Provider Demographics
NPI:1831876853
Name:MILLARD, ANNA BROOKE SPARKS
Entity type:Individual
Prefix:
First Name:ANNA BROOKE
Middle Name:SPARKS
Last Name:MILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47969 US HIGHWAY 78
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AL
Mailing Address - Zip Code:35096-6757
Mailing Address - Country:US
Mailing Address - Phone:256-322-8632
Mailing Address - Fax:
Practice Address - Street 1:47969 US HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AL
Practice Address - Zip Code:35096-6757
Practice Address - Country:US
Practice Address - Phone:256-322-8632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health