Individual
STARLA MAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 WARRIOR LANE, POPLAR BLUFF, MO 63901
(573) 421-2017
Mailing address
3001 WARRIOR LANE, POPLAR BLUFF, MO 63901
(573) 421-2017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
S086227022
MO
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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