Individual
TAYLOR NICHOLE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 W WATER ST, MOCKSVILLE, NC 27028
(470) 516-6626
Mailing address
1959 N PEACE HAVEN RD # 104, WINSTON SALEM, NC 27106-4850
(336) 560-7878
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69032
NC
103K00000X
Behavior Analyst
1304
NC
Other
Enumeration date
07/27/2020
Last updated
01/08/2026
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