Provider Demographics
NPI:1881022341
Name:PERCICH, STEPHANIE LYNN (MS, CGC)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:PERCICH
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 1:8200 E BELLEVIEW AVE STE 200E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2857
Mailing Address - Country:US
Mailing Address - Phone:720-493-3446
Mailing Address - Fax:720-874-4405
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 200E
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2857
Practice Address - Country:US
Practice Address - Phone:720-493-3446
Practice Address - Fax:720-874-4405
Is Sole Proprietor?:No
Enumeration Date:2013-10-21
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS