JAXSON STARK, MS
Counselor - Mental Health
Active
Individual
NPI: 1144559527
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor - Mental Health | 101YM0800X | Yes | LCPC 5501 (ID) |
Frequently Asked Questions
NPI 1144559527 is the National Provider Identifier for JAXSON STARK, MS, a Counselor - Mental Health provider located in Ammon, ID. This NPI was enumerated on December 15, 2009.
JAXSON STARK, MS practices at 2705 E 17TH ST, Ammon, ID 83406.
Quick Facts
- NPI
- 1144559527
- Type
- Individual
- Enumerated
- Dec 15, 2009
- Last Updated
- Dec 6, 2023
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