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Organization
STACEY KOEKKOEK
Active
Organization
STACEY KOEKKOEK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY KOEKKOEK MS RD, LDN, LMHC (PSYCHOTHERAPIST/DIETITIAN)
(508) 276-1743
Entity
Organization
Contact information
Practice address
260 BOSTON POST RD, SUITE 11, WAYLAND, MA 01778-1889
(508) 276-1743
Mailing address
260 BOSTON POST RD, SUITE 11, WAYLAND, MA 01778-1889
(508) 276-1743
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8490
MA
Other
Enumeration date
03/27/2014
Last updated
04/04/2017
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