Individual provider · Type 1 NPI

Andrew Stark

Mental Health Counselor · Dallas, OR

NPI number 1093123374 Active

Practice location

182 SW Academy St, Suite 333
Dallas, OR 97338-1922

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1093123374

Andrew Stark's National Provider Identifier is 1093123374, issued on Jul 30, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dallas, OR. The record was last updated on Jul 30, 2014.