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General NPI Number Information
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NPI Number | 1841273885
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Entity Type | Individual
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Provider Name | STEPHANIE L COOPER PHD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1600 22ND AVE FL 3
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City | MERIDIAN
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State | MS
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Zip | 39301-3223
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Country | US
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Telephone | 601-703-8370
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749215
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City | ATLANTA
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State | GA
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Zip | 30374-9215
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Country | US
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Telephone | 901-226-3186
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 614
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 46755
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License Number State | MS
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