Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 51827 | TX |
NPI | 1003175068 |
---|---|
Provider Name | Brandy Sparks |
First Address | Corpus Christi, TX 78460-0056 |
Second Address | Corpus Christi, TX 78405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2012 |
Last Update Date | 27/08/2018 |