Individual
MRS. JENNIFER DAWN STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
15 GRANT ST, PETERSBURG, WV 26847-1687
(304) 263-0811
Mailing address
PO BOX 21, RIVERTON, WV 26814-0021
(304) 567-3167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CP00939358
WV
1041C0700X
Clinical Social Worker
Primary
DP00939358
WV
Other
Enumeration date
10/03/2007
Last updated
01/09/2017
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