Individual
DR. STACY KOUTRAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1817 N 7TH ST, PHOENIX, AZ 85006-2133
(602) 741-1545
Mailing address
PO BOX 4353, SCOTTSDALE, AZ 85261-4353
(602) 741-1545
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3904
AZ
Other
Enumeration date
03/06/2008
Last updated
07/24/2008
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