NPI | 1548258619 |
---|---|
Former Name | MICHELLE D STARKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004059A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 34004059A) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2021-01-21 |