Provider Demographics
NPI:1851135453
Name:COOPER, SEQUOIA A
Entity type:Individual
Prefix:
First Name:SEQUOIA
Middle Name:A
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 1:5421 ROHDEN DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9105
Mailing Address - Country:US
Mailing Address - Phone:313-510-5939
Mailing Address - Fax:
Practice Address - Street 1:5421 ROHDEN DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9105
Practice Address - Country:US
Practice Address - Phone:313-510-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator