Doctor Name: | MS. PATRICIA ANN STARK |
NPI Number: | 1003053760 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | LCS17604 |
Business Practice Address: | 1600 Saint Michaels Dr Santa Fe, NM - 875057615 |
Business Phone Number: | 5054736362 |
Business Fax Number: | 5054736467 |
Mailing Address: | 1600 Saint Michaels Dr, SANTA FE |
State: | NM |
Postal Code: | 875057615 |
Phone Number: | 5054736362 |
Fax Number: | 5054736467 |
NPI Enumeration Date: | 01/15/2009 |
NPI Last Update Date: | 09/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS17604 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |