Individual provider · NPI-1

Pamela A Bantam Cooper, M.S.

Psychologist · Lawrence, KS

NPI number1124067038
StatusActive
Last updated in NPPESMay 31, 2019

Details

NPI
1124067038
Entity type
Individual (NPI-1)
Name
Pamela A Bantam Cooper
Credential
M.S.
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 6, 2006
Last updated
May 31, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X PsychologistLCP 0109KSYes

Practice location

200 Maine St Ste A
Lawrence, KS 66044-1396

Phone 785-843-9192

Mailing address

200 Maine St Ste A
Lawrence, KS 66044-1396

Phone 785-843-9192

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