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NPI 1154848653

NPI 1154848653 : HEATHER COOPER THERAPIST : CHILLICOTHEE, OH

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General NPI Number Information
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    NPI Number           |    1154848653
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    Entity Type          |    Individual 
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    Provider Name        |    HEATHER COOPER THERAPIST
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/25/2017
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    Last Update Date     |    10/24/2025
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Provider Practice Location Address
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    Address Line         |    220 N PLAZA BLVD 
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    City                 |    CHILLICOTHEE
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    State                |    OH
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    Zip                  |    45601-1787
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    Country              |    US
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    Telephone            |    740-270-3286
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    Fax                  |    740-773-3985
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Provider Business Mailing Address
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    Address Line         |    PO BOX 55 
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    City                 |    WALTON
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    State                |    KY
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    Zip                  |    41094-0055
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    Country              |    US
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    Telephone            |    
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    E.2303412
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    License Number State |    OH
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