| Doctor Name: | MR. MATTHEW SHAWN COOPER |
| NPI Number: | 1295930329 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. LPC |
| License Number: | 4999 |
| Business Practice Address: | 12415 E 191st St S Bixby, OK - 740086600 |
| Business Phone Number: | 5396646602 |
| Business Fax Number: | 9183641904 |
| Mailing Address: | Po Box 4155, TULSA |
| State: | OK |
| Postal Code: | 741590155 |
| Phone Number: | 5396646602 |
| Fax Number: | 9183641904 |
| NPI Enumeration Date: | 06/19/2007 |
| NPI Last Update Date: | 09/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4999 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |