Provider Demographics
NPI:1366757684
Name:WOYCIECHOWSKI, STACY (MS CGC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:WOYCIECHOWSKI
Suffix:
Gender:F
Credentials:MS CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 CIVIC CENTER BLVD
Mailing Address - Street 2:ARC RM. 703E
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4318
Mailing Address - Country:US
Mailing Address - Phone:267-426-7484
Mailing Address - Fax:215-590-5454
Practice Address - Street 1:3615 CIVIC CENTER BLVD
Practice Address - Street 2:ARC RM. 703E
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4318
Practice Address - Country:US
Practice Address - Phone:267-426-7484
Practice Address - Fax:215-590-5454
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS