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Individual

DR. JOHN THOMAS COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3188 ATLANTA RD SE, SMYRNA, GA 30080-8256
(770) 435-7770
(770) 435-9440
Mailing address
227 SANDY SPRINGS PL NE, SUITE D375, SANDY SPRINGS, GA 30328-5918
(770) 435-7770
(770) 435-9440

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001460
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00441548D
GA
Enumeration date
01/20/2010
Last updated
01/20/2010
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