Healthcare Provider Details

I. General information

NPI: 1992157952
Provider Name (Legal Business Name): STARK SPEECH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 08/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7265 PORTAGE ST NW SUITE B
MASSILLON OH
44646-6101
US

IV. Provider business mailing address

7265 PORTAGE ST NW SUITE B
MASSILLON OH
44646-6101
US

V. Phone/Fax

Practice location:
  • Phone: 330-249-1153
  • Fax:
Mailing address:
  • Phone: 330-249-1153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NORRIS
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential:
Phone: 330-249-1153