Individual
AMANDA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 DUNN AVE STE 2, JACKSONVILLE, FL 32218-4603
(904) 420-2304
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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