Individual
MS. AMY DIANE COOPER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3 MAIN ST, SUITE 107, BURLINGTON, VT 05401-5216
(802) 651-7526
(802) 862-9158
Mailing address
3 MAIN ST, SUITE 107, BURLINGTON, VT 05401-5216
(802) 651-7526
(802) 862-9158
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
047-0000635
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105384
—
VT
Enumeration date
05/12/2006
Last updated
07/09/2007
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