Individual
SHELBY MARIE STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2400 VETERANS MEMORIAL DR, CAPE GIRARDEAU, MO 63701-9620
(573) 290-5870
Mailing address
155 PCR 912, SAINT MARY, MO 63673-7113
(573) 768-9458
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2012018295
MO
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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