Individual
DESTINEE SPARKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 BIELENBERG DR STE 102-104, WOODBURY, MN 55125-1700
(612) 445-8325
Mailing address
731 BIELENBERG DR, SUITES 102-104, WOODBURY, MN 55125
(612) 445-8326
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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