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General NPI Number Information
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NPI Number | 1598839417
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Entity Type | Individual
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Provider Name | TAMARA WILSON STARKEY MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17819 HUTCHINS DR
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City | MINNETONKA
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State | MN
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Zip | 55345-4106
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Country | US
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Telephone | 952-470-1186
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Fax |
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Provider Business Mailing Address
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Address Line | 5655 CHRISTMAS LAKE PT
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City | EXCELSIOR
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State | MN
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Zip | 55331-9102
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Country | US
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Telephone | 952-380-0169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14188
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License Number State | MN
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