NPI | 1740576321 |
---|---|
Former Name | STEPHANIE E STARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I1000327) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I.1000327) |
Enumeration Date | 2011-06-22 |
Last Update Date | 2022-09-13 |