Provider Demographics
NPI:1609228824
Name:SPARR, TIRSA
Entity type:Individual
Prefix:
First Name:TIRSA
Middle Name:
Last Name:SPARR
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 1:2329 COMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2705
Mailing Address - Country:US
Mailing Address - Phone:801-735-2131
Mailing Address - Fax:
Practice Address - Street 1:175 W B ST STE H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4575
Practice Address - Country:US
Practice Address - Phone:541-423-2633
Practice Address - Fax:541-299-5685
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health