Individual
DIANE SPARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7835 MAIN ST N STE 220, MAPLE GROVE, MN 55369-7072
(763) 400-7475
(763) 400-7473
Mailing address
7835 MAIN ST N STE 220, MAPLE GROVE, MN 55369-7072
(763) 400-7475
(763) 400-7473
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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