Provider Demographics
NPI:1285481168
Name:COOPER, JULIANNA (MT-BC)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FOSTER ST APT 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4063
Mailing Address - Country:US
Mailing Address - Phone:606-308-2872
Mailing Address - Fax:
Practice Address - Street 1:530 FOSTER ST APT 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4063
Practice Address - Country:US
Practice Address - Phone:606-308-2872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16943225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist