Individual
CODY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
3433 DEER PATH RD, ROCKFORD, IL 61107-1110
(815) 319-8867
Mailing address
3433 DEER PATH RD, ROCKFORD, IL 61107-1110
(815) 319-8867
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-37310
IL
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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