Provider Demographics
NPI:1306262696
Name:COOPER, CAREY-ANNE (BC-HIS)
Entity type:Individual
Prefix:
First Name:CAREY-ANNE
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1127 KAUIKI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2818
Mailing Address - Country:US
Mailing Address - Phone:808-220-4883
Mailing Address - Fax:808-488-0623
Practice Address - Street 1:98-450 KAMEHAMEHA HIGHWAY
Practice Address - Street 2:#4
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3215
Practice Address - Country:US
Practice Address - Phone:808-488-9987
Practice Address - Fax:808-488-0623
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI170237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist