Individual
STACIE M KOSKINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 432-5966
Mailing address
2050 RIVERSIDE DR STE 108, GREEN BAY, WI 54301-2364
(920) 259-2307
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3306
WI
101YP2500X
Professional Counselor
Primary
7709
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932642592
—
WI
Enumeration date
11/29/2016
Last updated
12/20/2023
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