Individual
PAMELA A BANTAM COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
200 MAINE ST STE A, LAWRENCE, KS 66044-1396
(785) 843-9192
Mailing address
200 MAINE ST STE A, LAWRENCE, KS 66044-1396
(785) 843-9192
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LCP 0109
KS
Other
Enumeration date
06/06/2006
Last updated
05/31/2019
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