STACEY KOEKKOEK NPI 1316364375

NPI Information

STACEY KOEKKOEK is a mental health counselor in Wayland, MA. STACEY KOEKKOEK NPI is 1316364375. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

260 BOSTON POST RD
SUITE 11
WAYLAND, MA
ZIP 01778-889
Phone: (508) 276-1743

The provider's authorized official is Stacey Koekkoek .
The authorized official title is Psychotherapist/dietitian and has the following contact phone number (508) 276-1743.

The enumeration date for this NPI number is 3/27/2014 and was last updated on 4/4/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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