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Individual

HEATHER MICHELLE COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
133 FAIRVIEW AVE, SARDINIA, OH 45171-9354
(937) 515-2439
Mailing address
PO BOX 45, SARDINIA, OH 45171-0045
(937) 515-2439

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0800182
OH
Enumeration date
02/22/2023
Last updated
02/22/2023
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