Provider Demographics
NPI:1386116481
Name:COOPER, ADRIANA DECHELLE
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:DECHELLE
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 1:601 HOMER RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-2909
Mailing Address - Country:US
Mailing Address - Phone:318-371-6707
Mailing Address - Fax:318-377-8164
Practice Address - Street 1:601 HOMER RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-2909
Practice Address - Country:US
Practice Address - Phone:318-371-6707
Practice Address - Fax:318-377-8164
Is Sole Proprietor?:No
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator