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General NPI Number Information
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NPI Number | 1013743699
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Entity Type | Individual
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Provider Name | KENNIA SARAHI COOPER
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Gender | Female
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Dates
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Enumeration Date | 09/11/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 817 WESTCOTT LN
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City | ANTIOCH
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State | TN
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Zip | 37013-5272
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Country | US
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Telephone | 615-243-0968
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Fax |
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Provider Business Mailing Address
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Address Line | 3121 BAKERTOWN STATION WAY
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City | KNOXVILLE
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State | TN
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Zip | 37931-4072
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Country | US
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Telephone | 865-256-3955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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