Provider Information for 1538832589
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Mrs. CASANDRA MARIA STARBACK LMSW
Sex: Female
NPI: 1538832589
Last Updated: 2024-01-19
Certification Date: 2024-01-19
Certification Date: 2024-01-19
Details
Name | Value | ||||||||
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NPI | 1538832589 | ||||||||
Enumeration Date | 2021-07-27 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 8425 PARKRIDGE DR DEXTER, MI 48130-9398 United States Phone: 248-880-3700 | Fax: | ||||||||
Primary Practice Address | 220 COLLINGWOOD ST STE 140 ANN ARBOR, MI 48103-3842 United States Phone: 734-369-6163 | Fax: | ||||||||
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