Individual
KIMBERLY S. STARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A.01577
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000259545
OH MEDICAID UNISON
OH
05
—
0098592
—
OH
01
—
310917085190
OH MEDICAID CARESOURCE
OH
05
—
3810011309
—
WV
01
—
P00711132
RAIL ROAD MEDICARE
—
Enumeration date
10/24/2007
Last updated
12/22/2020
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