Healthcare Provider Details

I. General information

NPI: 1932625613
Provider Name (Legal Business Name): BRITTNEY LYNEE' SPARKS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTNEY LYNEE' BAYNES

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 TOWNCENTER DR STE 685
CLEMMONS NC
27012-9376
US

IV. Provider business mailing address

6255 TOWNCENTER DR STE 685
CLEMMONS NC
27012-9376
US

V. Phone/Fax

Practice location:
  • Phone: 336-422-6518
  • Fax:
Mailing address:
  • Phone: 336-422-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number11964
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: