Doctor Name: | STEPHANIE ELIZABETH KOPECKY |
NPI Number: | 1427324078 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 65706 |
Business Practice Address: | 100 Eagle Nest Ct Richwood, TX - 775664765 |
Business Phone Number: | 9792998548 |
Business Fax Number: | 2819661692 |
Mailing Address: | 201 E Myrtle St, Ste 139 ANGLETON |
State: | TX |
Postal Code: | 775154763 |
Phone Number: | 9792998548 |
Fax Number: | 2819661692 |
NPI Enumeration Date: | 03/28/2012 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 65706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |