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General NPI Number Information
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NPI Number | 1134094543
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Entity Type | Individual
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Provider Name | AMBER ANNE COOPER
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Gender | Female
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 6995 W 48TH ST
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City | FREMONT
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State | MI
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Zip | 49412-9506
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Country | US
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Telephone | 231-335-1718
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Fax |
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Provider Business Mailing Address
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Address Line | 6090 PAT ST
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City | FREMONT
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State | MI
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Zip | 49412-9669
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Country | US
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Telephone | 231-335-1718
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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 | 6451024620
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License Number State | MI
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