STACY DARNELL SPARKS

SAN BERNARDINO, CA
NPI1235449927
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2010-10-14
Last Update Date2010-10-14
Business Address
Mr. STACY DARNELL SPARKS
1963 N E ST
SAN BERNARDINO, CA 92405-3919
Phone number: 909-881-6146
Mailing Address
Mr. STACY DARNELL SPARKS
1963 N E ST
SAN BERNARDINO, CA 92405-3919
Phone number: 909-881-6146