Individual
SUSAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 MONONA DR STE 312, MONONA, WI 53716-3561
(608) 571-3560
Mailing address
5900 MONONA DR STE 312, MONONA, WI 53716-3561
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49108
BILLING ID NUMBER
WI
Enumeration date
11/15/2017
Last updated
11/15/2017
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