Individual
JACK SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 ENERGY PARK DR, SAINT PAUL, MN 55108-5229
(913) 328-4708
Mailing address
1515 ENERGY PARK DR, SAINT PAUL, MN 55108-5229
(816) 588-9591
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
03989
KS
101YP2500X
Professional Counselor
Primary
5590
MN
Other
Enumeration date
01/14/2022
Last updated
05/10/2026
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