MEDICARE: DR. JOAN BETH COOPER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2997	NJ

General Provider Information

NPI Number	:	1730563701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN BETH COOPER PH.D.

Provider Business Mailing Address
First Line	:	302 N WASHINGTON AVE
Second Line	:	SUITE 202 WEST
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-2448
Country	:	US
Telephone Number	:	856-866-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 N WASHINGTON AVE
Second Line	:	SUITE 202 WEST
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-2448
Country	:	US
Telephone Number	:	856-866-9888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2015
Last Update Date	:	07/19/2015

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