Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | U1-0001963 | DE |
NPI | 1528536927 |
---|---|
Provider Name | Seretha T Cooper |
First Address | Smyrna, DE 19977-4480 |
Second Address | Dover, DE 19904-8717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 24/11/2021 |