Individual
WALTER E COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RECOVERY TECHNICIAN
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
Mailing address
3412 SPRINGLAKE DR., 26, OKLAHOMA CITY, OK 73105
(405) 905-8397
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
OK
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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