Provider Demographics
NPI:1164643458
Name:COOPER, AIMEE JEAN (BSW, LSW)
Entity Type:Individual
Prefix:MISS
First Name:AIMEE
Middle Name:JEAN
Last Name:COOPER
Suffix:
Gender:F
Credentials:BSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45176-1341
Mailing Address - Country:US
Mailing Address - Phone:513-724-8555
Mailing Address - Fax:513-724-0708
Practice Address - Street 1:549 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:OH
Practice Address - Zip Code:45176-1120
Practice Address - Country:US
Practice Address - Phone:513-724-7855
Practice Address - Fax:513-724-0708
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0027634104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker