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1942033238
AVIS SPARKS
BRANDON, MS
NPI
1942033238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2024-08-22
Last Update Date
2024-08-22
Business Address
AVIS SPARKS
613 MARQUETTE RD
BRANDON, MS 39042-3038
Phone number: 601-824-1692
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Mailing Address
AVIS SPARKS
4141 CRANE BLVD
JACKSON, MS 39216-3406
Phone number: 601-622-5283
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