Healthcare Provider Details

I. General information

NPI: 1972448249
Provider Name (Legal Business Name): AMBER SPARKS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 ROGERS RD
MONROE NC
28110-7362
US

IV. Provider business mailing address

604 CHURCH ST
LOCUST NC
28097-9621
US

V. Phone/Fax

Practice location:
  • Phone: 704-296-3035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: