Healthcare Provider Details

I. General information

NPI: 1518320068
Provider Name (Legal Business Name): DARCI COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 ASHLAND AVE
COLUMBUS OH
43212-2795
US

IV. Provider business mailing address

1504 ASHLAND AVE
COLUMBUS OH
43212-2795
US

V. Phone/Fax

Practice location:
  • Phone: 513-227-8329
  • Fax:
Mailing address:
  • Phone: 513-227-8329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number10-061
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: