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General NPI Number Information
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NPI Number | 1457836876
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Entity Type | Individual
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Provider Name | DARRECIA PRINCESS COOPER M.A.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 801 W BIG BEAVER RD STE 300
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City | TROY
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State | MI
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Zip | 48084-4725
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Country | US
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Telephone | 248-500-6411
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Fax | 248-243-0226
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Provider Business Mailing Address
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Address Line | 25835 MARY ST
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2824
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Country | US
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Telephone | 313-971-6693
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Fax | 248-243-0226
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401018613
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401013594
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401018613
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License Number State | MI
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