Individual
DR. DAVINE S. SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LCSW
Contact information
Practice address
2828 WESLEY CHAPEL RD, DECATUR, GA 30034-2313
(678) 232-2765
Mailing address
6302 STABLEWOOD WAY, LITHONIA, GA 30058-8975
(678) 232-2765
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001555
GA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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