Provider Demographics
NPI:1396819520
Name:SPARKS, ROSANN ELIZABETH (LMFT)
Entity type:Individual
Prefix:
First Name:ROSANN
Middle Name:ELIZABETH
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SW MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-3918
Mailing Address - Country:US
Mailing Address - Phone:816-525-5333
Mailing Address - Fax:816-525-5334
Practice Address - Street 1:519 SW MARKET ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-3918
Practice Address - Country:US
Practice Address - Phone:816-525-5333
Practice Address - Fax:816-525-5334
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002006282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist