Sheila Marie Sparks, OT

Individual provider Active NPI Neurorehabilitation Occupational Therapist · Lake City, TN

NPI 1609090265 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1609090265
Entity type
Individual (NPI type 1)
Primary specialty
Neurorehabilitation Occupational Therapist 225XN1300X
License
01493 (TN)
Practice address
204 Industrial Park Road
Lake City, TN 37769
Phone
(865) 426-2147
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
01493TNMDNeurorehabilitation Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 01493 TN Yes

Addresses

Primary practice location

204 Industrial Park Road
Lake City, TN 37769

Mailing address

9546 Trails End Rd
Knoxville, TN 37931-4219
Phone (865) 368-9582

Other providers in Lake City, TN

All providers in Lake City, TN · Neurorehabilitation Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.