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General NPI Number Information
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NPI Number | 1659502003
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Entity Type | Individual
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Provider Name | SHARIBETH COOPER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 12581 MILSTEAD WAY STE 302
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5445
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Country | US
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Telephone | 703-239-7336
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Fax |
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Provider Business Mailing Address
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Address Line | 2609 FOXHALL MNR
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City | SCOTT AFB
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State | IL
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Zip | 62225-1453
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Country | US
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Telephone | 306-728-2224
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.007385
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056.007385
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License Number State | IL
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