Individual
STACEY KOKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2674 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7157
(561) 572-6832
Mailing address
2674 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7157
(561) 572-6832
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/09/2020
Last updated
06/28/2024
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