Individual
DAVID COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
415 E COOK RD, STE 100, FORT WAYNE, IN 46825-3636
(260) 489-6030
Mailing address
415 E COOK RD, STE 100, FORT WAYNE, IN 46825-3636
(260) 489-6030
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34000392
IN
Other
Enumeration date
04/24/2006
Last updated
03/28/2008
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