Sparkle L Nicks
Marriage & Family Therapist in Peoria, IL. Individual provider (NPI-1).
NPI number1124627005
StatusActive
Last updated in NPPESOct 21, 2020
Details
- NPI
- 1124627005
- Entity type
- Individual (NPI-1)
- Name
- Sparkle L Nicks
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2020
- Certification date
- Oct 21, 2020
- Last updated
- Oct 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
10508 Churchill DrPeoria, IL 61615-1178
Phone 309-706-3676
Mailing address
2610 W Richwoods BlvdPeoria, IL 61604-7112
Phone 309-323-6648
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All 16 Marriage & Family Therapist providers in Peoria · All 5,546 providers in Peoria
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