Healthcare Provider Details

I. General information

NPI: 1508465675
Provider Name (Legal Business Name): CINDY COOPER-BARRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 N ZION RD STE 112
SALISBURY MD
21801-2575
US

IV. Provider business mailing address

PO BOX 123
EASTON MD
21601-8901
US

V. Phone/Fax

Practice location:
  • Phone: 800-867-2395
  • Fax:
Mailing address:
  • Phone: 800-867-2395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAC0674
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: