Individual
MR. STANLEY COOPER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.I.
Contact information
Practice address
6400 BRENTWOOD DR, APT. 5, PADUCAH, KY 42003-9619
(270) 227-3194
Mailing address
6410 BRENTWOOD DR., APT. 5, PADUCAH, KY 42003
(270) 227-3194
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
09/13/2012
Last updated
07/19/2016
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