Provider Demographics
NPI:1609232081
Name:SPARKS, LINDA (ND)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:HAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2558 WHITNEY AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3045
Mailing Address - Country:US
Mailing Address - Phone:203-230-2200
Mailing Address - Fax:203-230-1454
Practice Address - Street 1:2558 WHITNEY AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3045
Practice Address - Country:US
Practice Address - Phone:203-230-2200
Practice Address - Fax:203-230-1454
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0990116157175F00000X
CT647175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath