Provider Demographics
NPI:1871253757
Name:COOPER, SULENG
Entity Type:Individual
Prefix:
First Name:SULENG
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SULENG
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2457 GREEN PINE DR APT 12
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1187
Mailing Address - Country:US
Mailing Address - Phone:810-553-2941
Mailing Address - Fax:
Practice Address - Street 1:2457 GREEN PINE DR APT 12
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-1187
Practice Address - Country:US
Practice Address - Phone:810-553-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula