Individual
LYNETTE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6416 LONG AVE, SHAWNEE, KS 66216-2566
(913) 631-2146
Mailing address
32665 W 171ST ST, GARDNER, KS 66030-9242
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00645
KS
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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