Organization
NEW SPARK THERAPY PLLC
Active
Organization
NEW SPARK THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINAKSHI RATKALKAR PH.D., LCSW (OWNER)
(215) 882-9949
Entity
Organization
Contact information
Practice address
3326 DURHAM CHAPEL HILL BLVD STE 230, DURHAM, NC 27707-6239
(215) 882-9949
Mailing address
3326 DURHAM CHAPEL HILL BLVD STE 230, DURHAM, NC 27707-6239
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TF0200X
Forensic Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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