Individual
AMY M SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1931 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3506
(203) 384-8681
(203) 384-9722
Mailing address
2900 MAIN ST, SUITE 1D, STRATFORD, CT 06614-4946
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002266
CT
Other
Enumeration date
12/01/2006
Last updated
08/14/2009
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