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Individual

GENNIFER COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2315 JO HAYWOOD DR, FORT PIERCE, FL 34946-1628
(772) 323-3345
Mailing address
2315 JO HAYWOOD DR, FORT PIERCE, FL 34946-1628
(772) 323-3345

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
374U00000X
Home Health Aide
Primary

Other

Enumeration date
11/05/2021
Last updated
11/05/2021
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