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Individual
KEVIN DOUGLAS STARK
Active
Individual
KEVIN DOUGLAS STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
2-3732
TX
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2-3732
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328753401
—
TX
05
—
328753402
—
TX
05
—
328753403
—
TX
Enumeration date
11/11/2008
Last updated
12/02/2014
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