Provider Demographics
NPI:1053417923
Name:SPARRY, JORI
Entity type:Individual
Prefix:
First Name:JORI
Middle Name:
Last Name:SPARRY
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 1:543 N MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-1935
Mailing Address - Country:US
Mailing Address - Phone:860-209-8222
Mailing Address - Fax:860-206-1190
Practice Address - Street 1:543 N MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1935
Practice Address - Country:US
Practice Address - Phone:860-209-8222
Practice Address - Fax:860-206-1190
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist