Individual
MELISSA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1941 WINDSOR SPRING RD, AUGUSTA, GA 30906-5821
(706) 495-5439
Mailing address
1941 WINDSOR SPRING RD, AUGUSTA, GA 30906-5821
(706) 495-5439
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001085
GA
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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