Provider Demographics
NPI:1083629745
Name:HOLDER-COOPER, JUDITH CLAIRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CLAIRE
Last Name:HOLDER-COOPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:CLAIRE
Other - Last Name:HOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2200 W MAIN ST
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4640
Mailing Address - Country:US
Mailing Address - Phone:919-286-1244
Mailing Address - Fax:919-286-1121
Practice Address - Street 1:2200 W MAIN ST
Practice Address - Street 2:SUITE 400A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4640
Practice Address - Country:US
Practice Address - Phone:919-286-1244
Practice Address - Fax:919-286-1121
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2321103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling