Individual
SUSAN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
402 91ST AVE NE, EVERETT, WA 98205-1530
(425) 334-4071
Mailing address
15206 HIGH BRIDGE RD, MONROE, WA 98272-8838
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002403
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8373268
—
WA
Enumeration date
12/16/2006
Last updated
07/09/2007
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