Provider Demographics
NPI:1447809454
Name:COOPER, TARA C (MED, MA)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:C
Last Name:COOPER
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Gender:F
Credentials:MED, MA
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Mailing Address - Street 1:160 BETHLEHEM PIKE STE 120
Mailing Address - Street 2:
Mailing Address - City:COLMAR
Mailing Address - State:PA
Mailing Address - Zip Code:18915-9790
Mailing Address - Country:US
Mailing Address - Phone:215-997-2000
Mailing Address - Fax:215-997-2282
Practice Address - Street 1:160 BETHLEHEM PIKE STE 120
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915-9790
Practice Address - Country:US
Practice Address - Phone:215-997-2000
Practice Address - Fax:215-997-2282
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2024-07-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health