Mellisa L Sparks, AT

NPI #1407179500 in Malvern, Arkansas

Provider Information

NPI Number: 1407179500
Entity Type: Individual
Name: Mellisa L Sparks, AT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: AT
Enumeration Date: Mar 4, 2010
Last Updated: Mar 4, 2010

Practice Location

Address: 1519 E PAGE AVE
City: Malvern
State: Arkansas
ZIP Code: 72104-4521
Phone: (501) 337-5600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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