Individual
COOPER BRUBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
704 EMMET ST, PETOSKEY, MI 49770-2910
(231) 347-9880
Mailing address
704 EMMET ST, PETOSKEY, MI 49770-2910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6801100374
MI
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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