Doctor Name: | TRACY SPARKS |
NPI Number: | 1003157454 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4958 |
Business Practice Address: | 6172 Airways Blvd Suite 122 Chattanooga, TN - 374212984 |
Business Phone Number: | 4236221551 |
Business Fax Number: | 8778567133 |
Mailing Address: | 6172 Airways Blvd, Suite 122 CHATTANOOGA |
State: | TN |
Postal Code: | 374212984 |
Phone Number: | 4236221551 |
Fax Number: | 8778567133 |
NPI Enumeration Date: | 03/11/2013 |
NPI Last Update Date: | 03/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4958 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |