Individual
MICHAEL SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
3250 HOSPITAL DR, JUNEAU, AK 99801-7808
(907) 796-8690
Mailing address
3260 HOSPITAL DR, JUNEAU, AK 99801-7808
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
CSW.09929354
CO
Other
Enumeration date
06/18/2021
Last updated
06/20/2023
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