Individual
JENNIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1901 MEDI PARK DR, SUITE 65, AMARILLO, TX 79106-2110
(806) 468-7611
(806) 468-7603
Mailing address
307 PARTRIDGE DR, AMARILLO, TX 79124-1415
(806) 359-6847
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209654
TX
Other
Enumeration date
07/06/2008
Last updated
07/06/2008
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