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Individual
LENISA HARRIS COOPER
Active
Individual
LENISA HARRIS COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDER
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0323961
—
OH
01
—
7103017
INDEPENDENT PROVIDER NUMBER
—
Enumeration date
01/16/2020
Last updated
01/16/2020
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