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Individual

MR. MARK DOUGLAS COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
421 E 3RD ST, NEWPORT, KY 41071-1726
(510) 541-4321
Mailing address
421 E 3RD ST, NEWPORT, KY 41071-1726

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
2470A2800X
Assistant Health Information Record Technician
Primary

Other

Enumeration date
07/05/2007
Last updated
05/16/2022
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