Individual
MRS. JOANN ALLEN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDN
Contact information
Practice address
1 ABELE DR, CLIFTON PARK, NY 12065-2951
(518) 371-1400
(518) 371-1240
Mailing address
196 OLD GALE HILL RD, EAST CHATHAM, NY 12060-1802
(518) 766-6307
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005245-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
831685
REGISTRATION NUMBER
NY
Enumeration date
03/20/2007
Last updated
07/08/2007
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