Individual
MS. MADELINE A STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1225 ST FRANCIS DR SUITE F, SANTA FE, NM 87505
(505) 989-7777
(505) 989-4357
Mailing address
HC 70 BOX 371, PECOS, NM 87552
(505) 757-6851
(505) 989-4357
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
NM3807
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NM101190
—
NM
Enumeration date
12/27/2006
Last updated
07/08/2007
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