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General NPI Number Information
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NPI Number | 1427299437
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Entity Type | Organization
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Legal Business Name | JOAN T COOPER PHD PA
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 8259 N MILITARY TRL SUITE 12
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6352
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Country | US
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Telephone | 561-776-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 8259 N MILITARY TRL SUITE 12
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6352
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Country | US
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Telephone | 561-776-2260
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOAN T COOPER
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Credential | PHD
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Telephone | 561-776-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7117
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License Number State | FL
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