Individual
BETHANY GRACE COOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 W CHESTNUT ST STE 6, ROGERS, AR 72756-3520
(479) 346-5459
Mailing address
2323 W CHESTNUT ST STE 6, ROGERS, AR 72756-3520
(479) 346-5459
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-29666
AR
Other
Enumeration date
07/08/2022
Last updated
03/05/2024
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