Individual
CHANCIE MARIE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(918) 308-5512
(918) 786-4435
Mailing address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(918) 308-5512
(918) 786-4435
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/15/2020
Last updated
11/23/2020
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