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Individual
RICHARD COOPER JR.
Active
Individual
RICHARD COOPER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704319576
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704319576
MI
Other
Enumeration date
01/05/2021
Last updated
07/08/2026
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