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Individual

MS. JESSICA MICHELLE STARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RDN, LDN

Contact information

Practice address
118 TEMECULA DR, WEST MONROE, LA 71292-0476
(318) 557-9329
Mailing address
118 TEMECULA DR, WEST MONROE, LA 71292-0476
(318) 557-9329

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1095239
LA

Other

Enumeration date
12/17/2018
Last updated
12/17/2018
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