Individual
ERRICKA STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAPSW, BCBA
Contact information
Practice address
6601 WASHINGTON AVE, RACINE, WI 53406-3923
(262) 880-5864
(262) 995-7333
Mailing address
6601 WASHINGTON AVE, RACINE, WI 53406-3923
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
214-140
WI
104100000X
Social Worker
128554-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-28076
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
214-140
DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
08/28/2014
Last updated
01/18/2018
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