Provider Demographics
NPI:1992199574
Name:COOPER, ERICA (BCBA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 BIGHORN PASS SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-8788
Mailing Address - Country:US
Mailing Address - Phone:678-983-2939
Mailing Address - Fax:
Practice Address - Street 1:2440 FAIRBURN RD SW STE 101
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5256
Practice Address - Country:US
Practice Address - Phone:470-419-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst