Individual
MS. STEPHANIE ANN SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAPC
Contact information
Practice address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 533-1391
Mailing address
6056 BISHOPS PL, SAINT LOUIS, MO 63109-3300
(314) 352-2396
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/10/2008
Last updated
03/10/2008
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