Provider Demographics
NPI:1174884217
Name:SPARR, MELISSA A (OTR/L)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:SPARR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-1334
Mailing Address - Country:US
Mailing Address - Phone:773-332-6057
Mailing Address - Fax:
Practice Address - Street 1:CHERRY CREEK SCHOOL DISTRICT NUMBER 5
Practice Address - Street 2:4850 S YOSEMITE STREET
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1308
Practice Address - Country:US
Practice Address - Phone:303-773-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003457225X00000X
AK2418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty