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1124627005
SPARKLE L NICKS
PEORIA, IL
NPI
1124627005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2020-10-21
Last Update Date
2020-10-21
Business Address
SPARKLE L NICKS
10508 CHURCHILL DR
PEORIA, IL 61615-1178
Phone number: 309-706-3676
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Mailing Address
SPARKLE L NICKS
2610 W RICHWOODS BLVD
PEORIA, IL 61604-7112
Phone number: 309-323-6648
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