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General NPI Number Information
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NPI Number | 1942382536
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Entity Type | Individual
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Provider Name | TERRI LYNN COPANS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 327 FULLERTON AVE SUITE 2
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City | NEWBURGH
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State | NY
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Zip | 12550-3726
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Country | US
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Telephone | 845-232-1331
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Fax |
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Provider Business Mailing Address
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Address Line | 372 FULLERTON AVE SUITE 2
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City | NEWBURGH
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State | NY
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Zip | 12550-3744
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Country | US
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Telephone | 845-623-2133
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35SI00411400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 015108-1
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License Number State | NY
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