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General NPI Number Information
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NPI Number | 1801586821
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Entity Type | Individual
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Provider Name | MARIA ISABEL GALLARDO-COOPER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 3301 COLLEGE AVE
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City | DAVIE
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State | FL
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Zip | 33314-7796
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Country | US
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Telephone | 954-262-5730
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Fax |
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Provider Business Mailing Address
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Address Line | 146 VIA CASTILLA
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City | JUPITER
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State | FL
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Zip | 33458-6919
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Country | US
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Telephone | 561-262-8818
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT565
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License Number State | FL
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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 | SS213
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License Number State | FL
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