Individual
JEANNE L STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3351 CLAYSTONE ST SE, STE. 212, GRAND RAPIDS, MI 49546-5781
(616) 954-1992
(616) 954-1998
Mailing address
4211 PARKWAY PL SW, GRANDVILLE, MI 49418-2695
(616) 530-9011
(616) 530-9011
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801088180
MI
Other
Enumeration date
12/13/2006
Last updated
01/05/2012
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