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General NPI Number Information
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NPI Number | 1750527206
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Entity Type | Individual
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Provider Name | AMY COOPER LPC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 44539 STERLING HWY SUITE 204
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City | SOLDOTNA
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State | AK
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Zip | 99669-7920
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Country | US
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Telephone | 907-420-0614
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Fax | 907-420-0614
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Provider Business Mailing Address
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Address Line | PO BOX 2912
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City | SOLDOTNA
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State | AK
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Zip | 99669-2912
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Country | US
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Telephone | 907-420-0614
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Fax | 907-420-0614
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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 | LCPC3232
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License Number State | ID
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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 | 587
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License Number State | AK
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