Individual
DANA MARIE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
Mailing address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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