| Doctor Name: | DIAN COOPER |
| NPI Number: | 1033300777 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RC00018324 |
| Business Practice Address: | 1057 12th Ave Longview, WA - 986322509 |
| Business Phone Number: | 3606363892 |
| Business Fax Number: | 3604141114 |
| Mailing Address: | 1057 12th Ave, LONGVIEW |
| State: | WA |
| Postal Code: | 986322509 |
| Phone Number: | 3606363892 |
| Fax Number: | 3604141114 |
| NPI Enumeration Date: | 08/07/2007 |
| NPI Last Update Date: | 08/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | RC00018324 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |