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1619422664
SHANICE S SPARKS
SHREVEPORT, LA
NPI
1619422664
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor Mental Health
Enumeration Date
2016-08-19
Last Update Date
2018-05-23
Business Address
MRS. SHANICE S SPARKS
6777 RASBERRY LN APT 2021
SHREVEPORT, LA 71129
Phone number: 318-393-5249
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Mailing Address
MRS. SHANICE S SPARKS
1648 MIDWAY ST
SHREVEPORT, LA 71108-2339
Phone number: 318-393-5249
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