Healthcare Provider Details

I. General information

NPI: 1760201586
Provider Name (Legal Business Name): ALAYNA COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8060 DAWN RD SW
SHERRODSVILLE OH
44675-9782
US

IV. Provider business mailing address

8060 DAWN RD SW
SHERRODSVILLE OH
44675-9782
US

V. Phone/Fax

Practice location:
  • Phone: 330-663-6269
  • Fax:
Mailing address:
  • Phone: 330-663-6269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: