Individual
BRANDY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 COMMERCIAL RD, HUNTINGTON, IN 46750-8805
(260) 459-6040
(260) 338-4914
Mailing address
5601 COVENTRY LN, FORT WAYNE, IN 46804-7145
(260) 459-6040
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-343241
IN
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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