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NPI Code Detail

MEDICARE: SASHA SHAMAE STARK

MEDICARE: SASHA SHAMAE STARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1679424675
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASHA SHAMAE STARK
Provider Business Mailing Address
First Line : 421 WALNUT ST
Second Line :
City : FARMINGTON
State : MN
Zip : 55024-1344
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 421 WALNUT ST
Second Line :
City : FARMINGTON
State : MN
Zip : 55024-1344
Country : US
Telephone Number : 612-252-2980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ SASHA SHAMAE STARK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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