Kelly Stark

NPI #1114343985 in Ammon, Idaho

Provider Information

NPI Number: 1114343985
Entity Type: Individual
Name: Kelly Stark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Mar 17, 2014
Last Updated: Nov 25, 2025

Practice Location

Address: 2705 E 17TH ST
City: Ammon
State: Idaho
ZIP Code: 83406-6669
Phone: (208) 346-7500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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