Individual
MS. JANE ROBERTA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PROFESSIONA
Contact information
Practice address
120 COLLEGE STREET, 600 PLAZA MIDDLESEX, MIDDLETOWN, CT 06457-3426
(860) 346-8889
Mailing address
120 COLLEGE STREET, 600 PLAZA MIDDLESEX, MIDDLETOWN, CT 06457-3426
(860) 346-8889
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000320
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240000320CT01
ANTHEM BLUE CROSS BS CT
CT
Enumeration date
10/30/2006
Last updated
07/08/2007
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