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Individual

MARIEL COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
906 LAKEVIEW AVE, MILFORD, DE 19963-1732
(302) 422-1600
Mailing address
906 LAKEVIEW AVE, MILFORD, DE 19963-1732

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
O1-0001623
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
O1-0001623
STATE LICENSE
DE
Enumeration date
08/30/2017
Last updated
08/30/2017
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