Provider Demographics
NPI:1972551042
Name:SPARKES, LYNN K (AUDIOLOGIST MA CCCA)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:K
Last Name:SPARKES
Suffix:
Gender:F
Credentials:AUDIOLOGIST MA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938
Mailing Address - Country:US
Mailing Address - Phone:207-778-9545
Mailing Address - Fax:207-778-0003
Practice Address - Street 1:201 FRONT ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938
Practice Address - Country:US
Practice Address - Phone:207-778-9545
Practice Address - Fax:207-778-0003
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP96231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
001604OtherBCBS
6500056003OtherCIGNA
001604OtherBCBS