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Individual

MARJORIE BARBARA COOPER-NICOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3512 QUENTIN RD, BROOKLYN, NY 11234-4231
(800) 275-3243
Mailing address
95 W 18TH ST, DEER PARK, NY 11729-3907
(631) 243-5835

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019594-1
NY

Other

Enumeration date
11/15/2006
Last updated
06/05/2012
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