Individual
DR. STEFANIE MARIE KOOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2620 N 140TH AVE STE 101, GOODYEAR, AZ 85395-2437
(623) 536-7956
Mailing address
2620 N 140TH AVE STE 101, GOODYEAR, AZ 85395-2437
(623) 536-7956
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4140
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z196224
PTAN
—
Enumeration date
09/16/2010
Last updated
05/02/2022
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