Individual
MS. KIMBERLY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 EAST 100 SOUTH, SALT LAKE CITY, UT 84111
(801) 322-4257
Mailing address
6968 S. PARK RESERVE WAY APT #301, MIDVALE, UT 84047-4713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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