Doctor Name: | MARGARET SPARKS |
NPI Number: | 1083773899 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CASE MANAGER |
License Number: | |
Business Practice Address: | 15145a Lakeshore Dr Clearlake, CA - 954228106 |
Business Phone Number: | 7079947090 |
Business Fax Number: | 7079947096 |
Mailing Address: | 16495 Rose St., Po Box 574 LOWER LAKE |
State: | CA |
Postal Code: | 95427 |
Phone Number: | 7079947090 |
Fax Number: | 7079947096 |
NPI Enumeration Date: | 12/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |