Individual
MRS. TERESA M STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2850 5TH AVE, HUNTINGTON, WV 25702-1436
(304) 528-5078
(304) 528-5344
Mailing address
2850 5TH AVE, HUNTINGTON, WV 25702-1436
(304) 528-5078
(304) 528-5344
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01093584
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153114000
—
WV
Enumeration date
01/29/2008
Last updated
01/29/2008
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