Individual
RACHAEL DEEANN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
2024 CHERRY HILL DR # 201C, COLUMBIA, MO 65203-5921
(573) 823-7192
Mailing address
105 AMANDA DR, ASHLAND, MO 65010-1204
(573) 424-0803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2018027688
MO
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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