Individual
MRS. COLEEN R SPARKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1115 14TH ST, MODESTO, CA 95354-1003
(209) 572-2589
(209) 572-1461
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
(209) 572-1461
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-3815
CA
Other
Enumeration date
05/31/2011
Last updated
08/06/2013
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