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General NPI Number Information
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NPI Number | 1043322076
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Entity Type | Individual
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Provider Name | PATRICIA V. COOPER PHD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 12380 DEPAUL DR. SSM REHABILITATION HOSPITAL - PHYSICIAN'S SERVICES
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City | BRIDGETON
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State | MO
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Zip | 63044-2588
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Country | US
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Telephone | 314-447-9705
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Fax | 314-447-9706
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Provider Business Mailing Address
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Address Line | 12380 DEPAUL DR. SSM REHABILATION HOSPITAL - PHYSICIAN'S SERVICES
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City | BRIDGETON
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State | MO
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Zip | 63044-2588
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Country | US
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Telephone | 314-447-9705
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Fax | 314-447-9706
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 01382
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 01382
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License Number State | MO
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