Individual
KORRIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
19772 MACARTHUR BLVD, SUITE #260, IRVINE, CA 92612-2413
(949) 891-0325
Mailing address
31912 9TH AVE, LAGUNA BEACH, CA 92651-6801
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
298139
CA
Other
Enumeration date
08/29/2012
Last updated
01/20/2017
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