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Individual

MS. REBECCA KYDD SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
2 CHURCH ST, SUITE 2D, BURLINGTON, VT 05401-4299
(802) 658-9590
Mailing address
2 CHURCH ST, SUITE 2D, BURLINGTON, VT 05401-4299
(802) 658-9590

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011661
VT
01
5103
BCBS
VT
Enumeration date
11/11/2006
Last updated
07/08/2007
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