Individual
PEGGY STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
320 MAC BLVD, NEVADA, MO 64772-3990
(888) 403-1071
(417) 667-6515
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020008501
MO
Other
Enumeration date
08/19/2017
Last updated
03/20/2020
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