Individual
GABRIELLE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 W BROAD ST, COLUMBUS, OH 43222-1319
(740) 505-4474
Mailing address
1206 W BROAD ST, COLUMBUS, OH 43222-1319
(740) 505-4474
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
06/21/2022
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