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Individual

JAYME COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3400 CROASDAILE DR, STE. 201, DURHAM, NC 27705-6815
(919) 382-0150
(919) 382-3390
Mailing address
3400 CROASDAILE DR, STE. 201, DURHAM, NC 27705-6815
(919) 382-0150
(919) 382-3390

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4067
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12198
BCBS
NC
05
7301311
NC
Enumeration date
08/21/2006
Last updated
07/08/2007
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