Individual
MACY MARIE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
78 VIA SANTO TOMAS, RANCHO MIRAGE, CA 92270-5816
(714) 856-8330
Mailing address
78 VIA SANTO TOMAS, RANCHO MIRAGE, CA 92270-5816
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
28978
CA
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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