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1235449927
STACY DARNELL SPARKS
SAN BERNARDINO, CA
NPI
1235449927
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-10-14
Last Update Date
2010-10-14
Business Address
Mr. STACY DARNELL SPARKS
1963 N E ST
SAN BERNARDINO, CA 92405-3919
Phone number: 909-881-6146
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Mailing Address
Mr. STACY DARNELL SPARKS
1963 N E ST
SAN BERNARDINO, CA 92405-3919
Phone number: 909-881-6146
Copy
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