Individual
MR. COREY DU JUAN STARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4880 N SABINO CANYON RD APT 4219, TUCSON, AZ 85750-7008
(816) 956-1487
Mailing address
4880 N SABINO CANYON RD APT 4219, TUCSON, AZ 85750-7008
(816) 956-1487
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1049220
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1049220
—
AZ
Enumeration date
01/14/2009
Last updated
01/14/2009
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