Individual
STACEY STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4570 VICTORIA ST N, SHOREVIEW, MN 55126-5800
(651) 621-6000
Mailing address
4570 VICTORIA ST N, SHOREVIEW, MN 55126-5800
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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