Sparks, Johanna Glen

Sparks, Johanna Glen is an individual health care provider with primary practice located at 1592 Mecklenburg Rd , Ithaca NY 14850-9243. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Sparks, Johanna Glen can be contacted via phone (607) 592-3209.

Contact Information

Primary practice address
1592 Mecklenburg Rd Ithaca NY 14850-9243
Phone: (607) 592-3209
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 001684-1 New York

Profile Details

NPI number 1508015611
LBN Legal business name Sparks, Johanna Glen
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2008
Last updated Sep 12th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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