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1407268667
ED SPARKS
WOODLAND, CA
NPI
1407268667
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-05-22
Last Update Date
2014-05-22
Business Address
-- ED SPARKS RASI
435 ASPEN ST
WOODLAND, CA 95695-2665
Phone number: 530-662-5727
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Mailing Address
-- ED SPARKS RASI
435 ASPEN ST
WOODLAND, CA 95695-2665
Phone number: 530-662-5727
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