| Doctor Name: | ROBERT S STARK |
| NPI Number: | 1194091223 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 6028 |
| Business Practice Address: | 1432 Grand Ave Glenwood Springs, CO - 816013808 |
| Business Phone Number: | 9709457858 |
| Business Fax Number: | 9709452475 |
| Mailing Address: | Po Box 1983, GLENWOOD SPRINGS |
| State: | CO |
| Postal Code: | 816021983 |
| Phone Number: | 9709457858 |
| Fax Number: | 9709452475 |
| NPI Enumeration Date: | 03/22/2012 |
| NPI Last Update Date: | 03/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | 6028 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |