Individual
KOOPER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
31 PASEO VISTA LOOP NE, RIO RANCHO, NM 87124-4469
(737) 222-4002
Mailing address
31 PASEO VISTA LOOP NE, RIO RANCHO, NM 87124-4469
(737) 222-4002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NM
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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