Doctor Name: | MRS. JANELL ANN STARK |
NPI Number: | 1538374012 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.T.R.S. |
License Number: | 50902 |
Business Practice Address: | 35514 Indigo Dr Sterling Heights, MI - 483104946 |
Business Phone Number: | 5862122671 |
Business Fax Number: | |
Mailing Address: | 21535 Colony St, SAINT CLAIR SHORES |
State: | MI |
Postal Code: | 480801841 |
Phone Number: | 5867744951 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225800000X |
License Number: | 50902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Recreation Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |