Individual
KELLI ANN STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
24998 HIGHWAY A, PRINCETON, MO 64673-4687
(660) 953-1246
Mailing address
24998 HIGHWAY A, PRINCETON, MO 64673-4687
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2014001138
MO
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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