Provider Demographics
NPI:1912285453
Name:COOPER, SARAH
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 CHERRY CREEK DRIVE
Mailing Address - Street 2:APT. # 1807
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246
Mailing Address - Country:US
Mailing Address - Phone:509-952-7401
Mailing Address - Fax:
Practice Address - Street 1:4550 CHERRY CREEK DRIVE
Practice Address - Street 2:APT. # 1807
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:509-952-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACOOPESD118CH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program