Individual
NICOLE LYNN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2445 PARK AVENUE, MINNEAPOLIS, MN 55404
(612) 343-3265
(612) 343-3267
Mailing address
2445 PARK AVE, MINNEAPOLIS, MN 55404-3714
(612) 343-3265
(612) 343-3267
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25435
MN
Other
Enumeration date
08/09/2017
Last updated
07/21/2022
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