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Individual

DR. STACY JORDAN CECCHET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1721 HEWITT AVE, SUITE 416, EVERETT, WA 98201-3570
(425) 789-1073
Mailing address
PO BOX 13221, EVERETT, WA 98206-3221

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
Primary
PY60401712
WA
103TC2200X
Clinical Child & Adolescent Psychologist
103TF0200X
Forensic Psychologist

Other

Enumeration date
11/07/2013
Last updated
11/07/2013
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