Organization
STARS OF WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE BURDA MASTROGIANIS PHD (DIRECTOR)
(586) 262-4153
Entity
Organization
Contact information
Practice address
10179 MILKY WAY CIR, SARASOTA, FL 34241-1503
(586) 262-4153
Mailing address
10179 MILKY WAY CIR, SARASOTA, FL 34241-1503
(586) 262-4153
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013176
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E03190
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/10/2011
Last updated
08/31/2023
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