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General NPI Number Information
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NPI Number | 1134293368
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Entity Type | Individual
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Provider Name | ANGELA O'NEILL SPARKS OTD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 27 FROST LN
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City | DAWSONVILLE
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State | GA
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Zip | 30534-4349
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Country | US
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Telephone | 404-436-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 27 FROST LN
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City | DAWSONVILLE
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State | GA
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Zip | 30534-4349
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Country | US
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Telephone | 404-436-0774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT1721
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT005505
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License Number State | GA
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