Individual
CRYSTAL SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 CLEVELAND HIGHWAY, DALTON, GA 30721
(706) 260-5235
Mailing address
2611 CLEVELAND HWY, DALTON, GA 30721-8160
(706) 260-5235
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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