Provider Demographics
NPI:1982374401
Name:COOPER, ARDEN MEKELLE (MA)
Entity type:Individual
Prefix:
First Name:ARDEN
Middle Name:MEKELLE
Last Name:COOPER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 ELMWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-8908
Mailing Address - Country:US
Mailing Address - Phone:571-271-8851
Mailing Address - Fax:
Practice Address - Street 1:3521 SILVERSIDE RD STE 2F1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4900
Practice Address - Country:US
Practice Address - Phone:571-271-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program