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Individual

LAVEEDA COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4518 TERI CT, MONTGOMERY, AL 36106-3540
(334) 777-6182
Mailing address
4518 TERI CT, MONTGOMERY, AL 36106-3540
(334) 777-6182

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164W00000X
Licensed Practical Nurse
2055434
AL
3747P1801X
Personal Care Attendant
AL
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
82-5313963
AL
Enumeration date
09/09/2021
Last updated
09/09/2021
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