Organization
MIND Y SPARKER CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY PARKER (OWNER)
(772) 559-1971
Entity
Organization
Contact information
Practice address
443 BOATWRIGHT DR, EASTPOINT, FL 32328-3445
(772) 559-1971
Mailing address
443 BOATWRIGHT DR, EASTPOINT, FL 32328-3445
(772) 559-1971
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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