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Individual

LELAND L SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
4285 N RANCHO DR STE 130, LAS VEGAS, NV 89130-3455
(702) 385-5331
(702) 385-5678
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
171M00000X
Case Manager/Care Coordinator
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
08/07/2012
Last updated
06/21/2023
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