Individual
MS. SHAUNA MARIE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1200 N CENTRAL AVE STE 110, KISSIMMEE, FL 34741-4439
(407) 201-7429
Mailing address
6386 VINELAND RD UNIT 102, ORLANDO, FL 32819-7854
(321) 305-9663
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10294
FL
Other
Enumeration date
01/17/2012
Last updated
11/05/2024
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