Provider Demographics
NPI:1225332570
Name:COOPER, RITA M (BCBA)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:M
Last Name:COOPER
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 NE CLUBHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-3051
Mailing Address - Country:US
Mailing Address - Phone:816-704-9089
Mailing Address - Fax:
Practice Address - Street 1:622 NE CLUBHOUSE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-3051
Practice Address - Country:US
Practice Address - Phone:814-862-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-15-21015103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst