Individual
TREVOR ALAN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
960 LAKLOEY DR, NORTH POLE, AK 99705-5356
(907) 978-5766
Mailing address
960 LAKLOEY DR, NORTH POLE, AK 99705-5356
(907) 978-5766
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/14/2018
Last updated
04/14/2018
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