Organization
SPARK PATH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA O SPARKS OTD, OTR/L (OWNER)
(770) 618-9200
Entity
Organization
Contact information
Practice address
27 FROST LN, DAWSONVILLE, GA 30534-4349
(770) 618-9200
(770) 618-9300
Mailing address
27 FROST LN, DAWSONVILLE, GA 30534-4349
(770) 618-9200
(770) 618-9300
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/25/2020
Last updated
05/12/2025
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