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1255092102
SHANNON SPARKS
XENIA, OH
NPI
1255092102
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CDCA.178872)
Enumeration Date
2022-01-04
Last Update Date
2022-01-04
Business Address
SHANNON SPARKS
36 N DETROIT ST
XENIA, OH 45385-2909
Phone number: 937-610-4673
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Mailing Address
SHANNON SPARKS
3103 DIXIE HWY
HAMILTON, OH 45015-1653
Phone number: 513-892-4673
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