Individual
JERRICA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
506 MANCHESTER EXPY, A13&14, COLUMBUS, GA 31904-6444
(706) 653-9343
Mailing address
506 MANCHESTER EXPY, A13&14, COLUMBUS, GA 31904-6444
(706) 653-9343
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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