| Doctor Name: | DR. STEFANIE MARIE KOOL |
| NPI Number: | 1629386289 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 4140 |
| Business Practice Address: | 159 W Wickenburg Way Wickenburg, AZ - 853902265 |
| Business Phone Number: | 9286680737 |
| Business Fax Number: | 9286846852 |
| Mailing Address: | 11511 W Orange Blossom Ln, AVONDALE |
| State: | AZ |
| Postal Code: | 853923536 |
| Phone Number: | 6233085135 |
| Fax Number: | 6233747470 |
| NPI Enumeration Date: | 09/16/2010 |
| NPI Last Update Date: | 09/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4140 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |