Provider Demographics
NPI:1093502965
Name:SPARKS, TAMI
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:SPARKS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 W GARDEN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-4752
Mailing Address - Country:US
Mailing Address - Phone:850-466-6368
Mailing Address - Fax:
Practice Address - Street 1:418 W GARDEN ST STE 203418W
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-4752
Practice Address - Country:US
Practice Address - Phone:850-466-6368
Practice Address - Fax:850-466-6368
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach