Organization
SPARK WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE HIBBARD (PARTNER)
(410) 245-2199
Entity
Organization
Contact information
Practice address
692B RITCHIE HWY STE 101, SEVERNA PARK, MD 21146-3938
(410) 245-2199
Mailing address
102 STAUFFER RD, SEVERNA PARK, MD 21146-3021
(410) 245-2199
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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