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General NPI Number Information
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NPI Number | 1669284089
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Entity Type | Individual
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Provider Name | RACQUEL SPARKS
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1629 K ST NW
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City | WASHINGTON
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State | DC
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Zip | 20006-1602
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Country | US
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Telephone | 240-428-0465
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Fax |
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Provider Business Mailing Address
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Address Line | 5106 EUGENE AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-5013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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