Individual
MARISA COOPERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W 9TH AVE STE BANDC, KING OF PRUSSIA, PA 19406-1209
(610) 831-1865
(803) 905-4431
Mailing address
2580 LIN DO CT, SUMTER, SC 29150-1832
(803) 905-4427
(803) 905-4431
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003545
PA
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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