Individual
GRAHAM ELLIOT ROME COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3554 ROUND BARN BLVD, SANTA ROSA, CA 95403-0929
(707) 571-3778
Mailing address
3554 ROUND BARN BLVD, SANTA ROSA, CA 95403-0929
(707) 571-3778
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60923579
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32078
PSYCHOLOGIST LICENSE
CA
01
—
PY60923579
PSYCHOLOGIST LICENSE
WA
Enumeration date
11/04/2019
Last updated
12/30/2021
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