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Individual
MS. PAMELA GOODFRIEND COOPER
Active
Individual
MS. PAMELA GOODFRIEND COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CAC III
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
575
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
405164
MEDICARE GROUP PTAN
CO
01
—
C809003
MEDICARE PTAN
CO
Enumeration date
12/20/2006
Last updated
09/09/2015
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