Individual
KELLY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
401 BOGLE ST, SUITE 102, SOMERSET, KY 42503-3823
(606) 676-0638
Mailing address
401 BOGLE ST, SUITE 102, SOMERSET, KY 42503-3823
(606) 676-0638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101588
KY
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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