Individual
DEBORAH SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
100 EXECUTIVE DR, LAFAYETTE, IN 47905-4884
(765) 447-9545
Mailing address
4239 W 660 S, LAFAYETTE, IN 47909-9249
(765) 538-3207
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001947A
IN
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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