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NPI Code Detail

MEDICARE: KAYLENE COOPER

MEDICARE: KAYLENE COOPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-25-411012

General Provider Information

NPI Number : 1336946573
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLENE COOPER
Provider Business Mailing Address
First Line : 3130 STATE LINE RD
Second Line :
City : NORTH BEND
State : OH
Zip : 45052-9731
Country : US
Telephone Number : 765-580-9423
Fax Number :
Provider Business Practice Location Address
First Line : 3130 STATE LINE RD
Second Line :
City : NORTH BEND
State : OH
Zip : 45052-9731
Country : US
Telephone Number : 765-580-9423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2025
Last Update Date : 02/26/2025

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Directions to “ KAYLENE COOPER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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