JOHANNA GLEN SPARKS

ITHACA, NY
NPI1508015611
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: NY  001684-1)
Enumeration Date2008-09-12
Last Update Date2008-09-12
Business Address
-- JOHANNA GLEN SPARKS OT
1592 MECKLENBURG RD
ITHACA, NY 14850-9243
Phone number: 607-592-3209
Mailing Address
-- JOHANNA GLEN SPARKS OT
1592 MECKLENBURG RD
ITHACA, NY 14850-9243
Phone number: 607-592-3209
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