Individual provider · NPI-1

Brian Daniel Cooper, OTR

Occupational Therapist · Saint Clair Shores, MI

NPI number1891833513
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1891833513
Entity type
Individual (NPI-1)
Name
Brian Daniel Cooper
Credential
OTR
Sex
Male
Sole proprietor
No
Enumeration date
Feb 2, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist1066418MIYes

Practice location

22333 Blackburn St
Saint Clair Shores, MI 48080-1307

Phone 586-206-7463

Mailing address

22333 Blackburn St
Saint Clair Shores, MI 48080-1307

Phone 586-206-7463

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