Individual
MRS. JESSICA SPARKS-ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6202 S LEWIS AVE STE J, TULSA, OK 74136-1064
(918) 584-4549
Mailing address
26980 E 122ND PL, COWETA, OK 74429-5102
(580) 369-8433
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200433730B
—
OK
Enumeration date
02/22/2012
Last updated
04/17/2019
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