Provider Demographics
NPI:1932462132
Name:SPARKS, BRITTNEY S (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:S
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5238 PEG LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-2163
Mailing Address - Country:US
Mailing Address - Phone:727-415-9410
Mailing Address - Fax:
Practice Address - Street 1:5238 PEG LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-2163
Practice Address - Country:US
Practice Address - Phone:727-415-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000004427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist