Individual
ERICA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 756-1500
Mailing address
1836 W 85TH AVE, APT I 255, MERRILLVILLE, IN 46410-8472
(219) 427-9714
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
33007437A
IN
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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