Individual
SUSAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
404 N HORTON ST, NAMPA, ID 83651-6541
(208) 465-4594
Mailing address
404 N HORTON ST, NAMPA, ID 83651-6541
(208) 465-4594
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-052
ID
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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