Kimberly Cooper, Psyd Pllc | |
73 Hammond St # 1811 Bangor ME 04401-4957 | |
(207) 762-7282 | |
Not Available |
Full Name | Kimberly Cooper, Psyd Pllc |
---|---|
Speciality | Clinic/Center |
Location | 73 Hammond St # 1811, Bangor, Maine |
Authorized Official Name and Position | Kimberly J Cooper (PSYCHOLOGIST) |
Authorized Official Contact | 2077627282 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kimberly Cooper, Psyd Pllc Po Box 1811 Bangor ME 04402-1811 Ph: () - | Kimberly Cooper, Psyd Pllc 73 Hammond St # 1811 Bangor ME 04401-4957 Ph: (207) 762-7282 |
NPI Number | 1750059564 |
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Provider Enumeration Date | 09/06/2021 |
Last Update Date | 09/06/2021 |
Certification Date | 09/06/2021 |
Medicare PECOS PAC ID | 5799174041 |
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Medicare Enrollment ID | O20211109000029 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750059564 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Kimberly Cooper |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1598747032 PECOS PAC ID: 9436125184 Enrollment ID: I20160613001430 |
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