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Individual

MR. GENE SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
(502) 589-8771
Mailing address
1516 NORRIS PL, APT 1, LOUISVILLE, KY 40205-1085
(502) 802-7079

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
34004246A
IN
1041C0700X
Clinical Social Worker
Primary
KY-322
KY

Other

Enumeration date
07/14/2006
Last updated
01/02/2008
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