Jeanine B Sparks, LPC

NPI #1104063056 in Wasilla, Alaska

Provider Information

NPI Number: 1104063056
Entity Type: Individual
Name: Jeanine B Sparks, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Jan 14, 2009
Last Updated: Jan 14, 2009

Practice Location

Address: 491 N KNIK ST
City: Wasilla
State: Alaska
ZIP Code: 99654-7049
Phone: (907) 727-8103

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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