Healthcare Provider Details

I. General information

NPI: 1083059091
Provider Name (Legal Business Name): MS. DANEE BLU COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2013
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7261 W CHARLESTON BLVD STE 101
LAS VEGAS NV
89117-1679
US

IV. Provider business mailing address

7520 FLORINE AVE
LAS VEGAS NV
89129-6044
US

V. Phone/Fax

Practice location:
  • Phone: 866-727-8274
  • Fax:
Mailing address:
  • Phone: 702-465-4026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: