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General NPI Number Information
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NPI Number | 1568502532
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Entity Type | Individual
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Provider Name | PAULA K COOPER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 345 MILWAUKEE AVE
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City | BURLINGTON
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State | WI
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Zip | 53105-1228
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Country | US
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Telephone | 262-763-9191
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Fax | 262-763-7767
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Provider Business Mailing Address
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Address Line | 345 MILWAUKEE AVE
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City | BURLINGTON
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State | WI
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Zip | 53105-1228
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Country | US
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Telephone | 262-763-9191
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Fax | 262-763-7767
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1859453
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 867-058
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License Number State | WI
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