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Individual

GRANT DEVON SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3720 CHAMBLEE DUNWOODY RD STE D2, CHAMBLEE, GA 30341-2064
(678) 802-9355
Mailing address
222 TURNBRIDGE CIR, PEACHTREE CITY, GA 30269-6505
(770) 312-2733

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/21/2021
Last updated
11/21/2021
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