Carlissa Simone Cooper
Technician/Technologist
32100 Telegraph Rd
Bingham Farms
, Michigan 48025-2452
Carlissa Simone Cooper
Technician/Technologist
32100 Telegraph Rd
Bingham Farms
, Michigan 48025-2452
(248) 712-4266
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About
Features
Specialties
- Technician/Technologist
Languages spoken
- English
Location
First Address
- Carlissa Simone Cooper
- 32100 Telegraph Rd Ste 205
- Bingham Farms, MI
- Zip : 48025-2454
- Phone : (248) 712-4266
Second Address
- Carlissa Simone Cooper
- 32100 Telegraph Rd
- Bingham Farms, MI
- Zip : 48025-2452
- Phone : (248) 712-4266
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Is Carlissa Simone Cooper accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist |
National Provider Identifier
| NPI | 1255937520 |
|---|---|
| Provider Name | Carlissa Simone Cooper |
| First Address | Bingham Farms, MI 48025-2454 |
| Second Address | Bingham Farms, MI 48025-2452 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.