Individual
MICHAEL SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW-P
Contact information
Practice address
108 CASTRO ST, NORMAN, OK 73069-5902
(405) 443-9183
Mailing address
108 CASTRO ST, NORMAN, OK 73069-5902
(405) 443-9183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027296586
—
OK
Enumeration date
04/03/2017
Last updated
08/26/2021
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