NPI | 1043521297 |
---|---|
Former Name | ELIZABETH B COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0093460) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 012558-1) |
Enumeration Date | 2010-06-22 |
Last Update Date | 2015-01-12 |