Individual
CHARLISA MARTRELL STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
108 W JASPER ST, VERSAILLES, MO 65084-1020
(573) 378-6833
Mailing address
18 PUCKETT RD, ELDON, MO 65026-4634
(573) 280-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2006033184
MO
Other
Enumeration date
02/23/2007
Last updated
07/09/2007
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