| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/06/2021 |
| Last Update Date | 09/06/2021 |
| Certification Date | 09/06/2021 |
| Medicare PECOS PAC ID | 5799174041 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598747032 PECOS PAC ID: 9436125184 Enrollment ID: I20160613001430 |
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