Provider Demographics
NPI:1316196215
Name:COOPER, VALETA M (PSYD)
Entity Type:Individual
Prefix:
First Name:VALETA
Middle Name:M
Last Name:COOPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2448
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-0448
Mailing Address - Country:US
Mailing Address - Phone:417-612-0250
Mailing Address - Fax:
Practice Address - Street 1:625 E VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1390
Practice Address - Country:US
Practice Address - Phone:417-612-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36627103TC0700X
MO2010023608103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1366779100OtherGREATER OZARKS RURAL PSYCHOLOGISTS, L.L.C