Individual
DANIELLE GRACE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9501
(317) 808-8802
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004912A
IN
225XH1200X
Hand Occupational Therapist
31004912A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062110018
MEDICARE PTAN
IN
05
—
201028770
—
IN
Enumeration date
02/23/2010
Last updated
04/01/2024
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