Cooper, Amy Diane

Cooper, Amy Diane is an individual health care provider with primary practice located at 3 Main St Suite 107, Burlington VT 05401-5216. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Cooper, Amy Diane can be contacted via phone (802) 651-7526.

Contact Information

Primary practice address
3 Main St Suite 107 Burlington VT 05401-5216
Phone: (802) 651-7526
Fax: (802) 862-9158
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 047-0000635 Vermont

Profile Details

NPI number 1962453449
LBN Legal business name Cooper, Amy Diane
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962453449 NPPES
Vermont MEDICAID 105384

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