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Individual

MISS MARY YANTIS COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
7807 BAYMEADOWS RD E, SUITE 200, JACKSONVILLE, FL 32256-9664
(904) 398-4133
(904) 398-4148
Mailing address
7807 BAYMEADOWS RD E, SUITE 200, JACKSONVILLE, FL 32256-9664
(904) 398-4133
(904) 398-4148

Taxonomy

Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
OT13813
FL

Other

Enumeration date
11/06/2009
Last updated
11/06/2009
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