Individual
ASHLEY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4840 GRASSELLI ST, EAST CHICAGO, IN 46312-3503
(219) 397-1085
Mailing address
6067 DECATUR BLVD, INDIANAPOLIS, IN 46241-9606
(317) 856-5201
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-376817
IN
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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