Individual
DR. NICOLE D COOPER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
109 W 2ND ST, CASA GRANDE, AZ 85122-4406
(520) 369-2511
Mailing address
PO BOX 12436, CASA GRANDE, AZ 85130-0619
(520) 369-2511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4353
AZ
Other
Enumeration date
02/20/2013
Last updated
02/20/2013
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