Individual
KYLIE A STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601-6434
(701) 227-7506
Mailing address
1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601-6434
(701) 227-7506
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1211-7-1-22
ND
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
Other
Enumeration date
10/08/2021
Last updated
07/24/2024
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