Provider Demographics
NPI:1033834338
Name:SPARKS, ERICA YVONNE
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:YVONNE
Last Name:SPARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602761
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-0761
Mailing Address - Country:US
Mailing Address - Phone:216-544-5601
Mailing Address - Fax:
Practice Address - Street 1:14595 BARTTER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3148
Practice Address - Country:US
Practice Address - Phone:216-544-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No171WH0202XOther Service ProvidersContractorHome Modifications
No172A00000XOther Service ProvidersDriver
No173C00000XOther Service ProvidersReflexologist
No1744R1102XOther Service ProvidersSpecialistResearch Study
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No211D00000XPodiatric Medicine & Surgery Service ProvidersAssistant, Podiatric
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner