| NPI | 1205495785 |
|---|---|
| Former Name | JULIA BRENNA MCCHESNEY STARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 8265) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2020-10-28 |