Provider Demographics
NPI:1164230298
Name:STARBUCK, ALLISON (HS, BT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:STARBUCK
Suffix:
Gender:F
Credentials:HS, BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 51ST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:MI
Mailing Address - Zip Code:49056-9515
Mailing Address - Country:US
Mailing Address - Phone:269-352-1085
Mailing Address - Fax:
Practice Address - Street 1:202 51ST ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:MI
Practice Address - Zip Code:49056-9515
Practice Address - Country:US
Practice Address - Phone:269-352-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician