Provider Demographics
NPI:1780862300
Name:COOPER, ELIZABETH ANNE CHAPMAN (MED)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE CHAPMAN
Last Name:COOPER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:1277 HORSHAM WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-6444
Mailing Address - Country:US
Mailing Address - Phone:919-622-7259
Mailing Address - Fax:
Practice Address - Street 1:1277 HORSHAM WAY
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-6444
Practice Address - Country:US
Practice Address - Phone:919-622-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCITFS222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist