Individual
KRISTINA M COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1300 N 12TH ST, SUITE 610, PHOENIX, AZ 85006-2848
(602) 239-5000
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 495-4577
(602) 417-3549
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1072
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176695
—
AZ
Enumeration date
03/24/2006
Last updated
10/06/2008
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