Graham Elliot Rome Cooper, PHD
Psychologist in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1164066064
StatusActive
Last updated in NPPESDec 30, 2021
Details
- NPI
- 1164066064
- Entity type
- Individual (NPI-1)
- Name
- Graham Elliot Rome Cooper
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2019
- Certification date
- Nov 12, 2020
- Last updated
- Dec 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PY60923579 | WA | Yes |
Practice location
3554 Round Barn BlvdSanta Rosa, CA 95403-0929
Phone 707-571-3778
Mailing address
3554 Round Barn BlvdSanta Rosa, CA 95403-0929
Phone 707-571-3778
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