Provider Demographics
NPI:1780919688
Name:COOPERMAN, MANUELA (MS)
Entity type:Individual
Prefix:MS
First Name:MANUELA
Middle Name:
Last Name:COOPERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MANUELA
Other - Middle Name:
Other - Last Name:IVALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1403
Mailing Address - Country:US
Mailing Address - Phone:781-793-7804
Mailing Address - Fax:
Practice Address - Street 1:4 BROOK RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1403
Practice Address - Country:US
Practice Address - Phone:781-793-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health