Doctor Name: | PATTY L STARK |
NPI Number: | 1114232188 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA MS EDS |
License Number: | |
Business Practice Address: | 400 W Colfax St Breckenridge, MO - 646259608 |
Business Phone Number: | 6606445715 |
Business Fax Number: | 6606445710 |
Mailing Address: | 400 W Colfax St, BRECKENRIDGE |
State: | MO |
Postal Code: | 646259608 |
Phone Number: | 6606445715 |
Fax Number: | 6606445710 |
NPI Enumeration Date: | 08/13/2010 |
NPI Last Update Date: | 08/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |