Individual
COOPER HENKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5032 S 2125 W, ROY, UT 84067-2543
(208) 220-5549
Mailing address
471 FAIRWAY DR, POCATELLO, ID 83201-2090
(208) 220-5549
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/07/2022
Last updated
05/07/2022
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