Individual
JOLENE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1101 E 78TH ST STE 100, BLOOMINGTON, MN 55420-1402
(952) 854-5034
Mailing address
17088 ADELMANN ST SE APT 308, PRIOR LAKE, MN 55372-2281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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