| Sparkle Healing Llc | |
|
4328 Farragut St Hyattsville MD 20781-2032 | |
| (240) 685-1940 | |
| Not Available |
| Full Name | Sparkle Healing Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4328 Farragut St, Hyattsville, Maryland |
| Authorized Official Name and Position | Tyler Mabry (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 2406851940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkle Healing Llc 4328 Farragut St Hyattsville MD 20781-2032 Ph: () - | Sparkle Healing Llc 4328 Farragut St Hyattsville MD 20781-2032 Ph: (240) 685-1940 |
| NPI Number | 1053038562 |
|---|---|
| Provider Enumeration Date | 10/25/2022 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053038562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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