Individual
MYKIA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 CENTERPOINT DR, MIDDLETOWN, CT 06457-7568
(203) 715-8481
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CT
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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