Individual
CODY G. SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP, LMLP, LMAC
Contact information
Practice address
809 ELMHURST BLVD, SALINA, KS 67401-7405
(785) 823-6322
(785) 823-3109
Mailing address
809 ELMHURST BLVD, SALINA, KS 67401-7405
(785) 823-6322
(785) 823-3109
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0133
KS
103T00000X
Psychologist
Primary
131
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004437030001
—
KS
Enumeration date
09/27/2006
Last updated
04/04/2024
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