| Doctor Name: | DR. PHYLLIS JANE GRAVES-COOPER |
| NPI Number: | 1124246434 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 012874 |
| Business Practice Address: | 967 Route 22 Brewster, NY - 105091526 |
| Business Phone Number: | 8455293900 |
| Business Fax Number: | 8452780444 |
| Mailing Address: | 1102 Scarborough Dr, BREWSTER |
| State: | NY |
| Postal Code: | 105096561 |
| Phone Number: | 8452780444 |
| Fax Number: | 8452780444 |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 12/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 012874 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |