Individual
MR. DERRICK COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
585 JOSEPH AVE, ROCHESTER, NY 14605-1215
(585) 325-4910
(585) 546-1491
Mailing address
585 JOSEPH AVE, ROCHESTER, NY 14605-1215
(585) 325-4910
(585) 546-1491
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
35422
NY
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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