Cooper, Susan Gayle

Cooper, Susan Gayle is an sole proprietor health care provider with primary practice located at 1050 Fox Acres Rd , Hailey ID 83333-8456. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Cooper, Susan Gayle can be contacted via phone (208) 720-3729.

Contact Information

Primary practice address
1050 Fox Acres Rd Hailey ID 83333-8456
Phone: (208) 720-3729
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT-475 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X

Profile Details

NPI number 1588222590
LBN Legal business name Cooper, Susan Gayle
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 4th, 2019
Last updated Jul 2nd, 2024 - about 5 months 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 1588222590 NPPES
Idaho Other OT-475 STATE LICENSE

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