Nicks, Sparkle L

Nicks, Sparkle L is an individual health care provider with primary practice located at 10508 Churchill Dr , Peoria IL 61615-1178. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Nicks, Sparkle L can be contacted via phone (309) 706-3676.

Contact Information

Primary practice address
10508 Churchill Dr Peoria IL 61615-1178
Phone: (309) 706-3676
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1124627005
LBN Legal business name Nicks, Sparkle L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2020
Last updated Oct 21st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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