Individual
MICHAEL STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 LOCK ST, NEW HAVEN, CT 06511-3603
(203) 432-0290
Mailing address
55 LOCK ST, NEW HAVEN, CT 06511-3603
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1507
NH
Other
Enumeration date
03/19/2022
Last updated
03/19/2022
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