Individual
DIANE STARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
330 E 400 S, SPRINGVILLE, UT 84663-2052
(801) 636-0997
(801) 785-0202
Mailing address
PO BOX 634, PLEASANT GROVE, UT 84062-0634
(801) 636-0997
(801) 785-0202
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
275939-3501
UT
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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