Individual
DR. MARK STANLEY KONECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6 HODGKINS ST, GLOUCESTER, MA 01930-1815
(978) 283-0333
(978) 283-0908
Mailing address
6 HODGKINS ST, GLOUCESTER, MA 01930-1815
(978) 283-0333
(978) 283-0908
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7627
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W05926
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/03/2007
Last updated
07/08/2007
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