Individual
ANDREA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-7199
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000164
MI
Other
Enumeration date
12/16/2018
Last updated
02/05/2021
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