Doctor Name: | STEPHANIE COCAGNE |
NPI Number: | 1023427713 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 178.008616 |
Business Practice Address: | 34 N Whistler Ave Freeport, IL - 610324069 |
Business Phone Number: | 8152356171 |
Business Fax Number: | 8152356172 |
Mailing Address: | 34 N Whistler Ave, FREEPORT |
State: | IL |
Postal Code: | 610324069 |
Phone Number: | 8152356171 |
Fax Number: | 8152356172 |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 178.008616 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |