Healthcare Provider Details

I. General information

NPI: 1003773540
Provider Name (Legal Business Name): TAKEIA COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 BRANDYWINE ST SE APT 303
WASHINGTON DC
20032-3551
US

IV. Provider business mailing address

701 BRANDYWINE ST SE APT 303
WASHINGTON DC
20032-3551
US

V. Phone/Fax

Practice location:
  • Phone: 240-405-7724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: