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Individual

BRENDA COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
122 ELK ST, WYANDANCH, NY 11798-3309
(718) 377-5000
(718) 377-5002
Mailing address
122 ELK ST, WYANDANCH, NY 11798-3309
(718) 377-5000
(718) 377-5002

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006466
NY

Other

Enumeration date
10/30/2018
Last updated
10/30/2018
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