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NPI Code Detail

MEDICARE: JORJA COOPER BCBA

MEDICARE: JORJA COOPER BCBA
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 Technician
2103K00000XBehavior Analyst308777KY

General Provider Information

NPI Number : 1982335840
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORJA COOPER BCBA
Provider Business Mailing Address
First Line : 116 BAYVIEW DR
Second Line :
City : RICHMOND
State : KY
Zip : 40475-7511
Country : US
Telephone Number : 859-940-3510
Fax Number :
Provider Business Practice Location Address
First Line : 116 BAYVIEW DR
Second Line :
City : RICHMOND
State : KY
Zip : 40475-7511
Country : US
Telephone Number : 859-575-4442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2022
Last Update Date : 06/05/2026

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