| Doctor Name: | ANDREW COOPER |
| NPI Number: | 1992164198 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LLC |
| License Number: | 6401015248 |
| Business Practice Address: | 9045 Us Highway 31 Berrien Springs, MI - 491031804 |
| Business Phone Number: | 2694732222 |
| Business Fax Number: | 2694736880 |
| Mailing Address: | 9045 Us Highway 31, BERRIEN SPRINGS |
| State: | MI |
| Postal Code: | 49103 |
| Phone Number: | 2694732222 |
| Fax Number: | 2694736880 |
| NPI Enumeration Date: | 02/16/2016 |
| NPI Last Update Date: | 02/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401015248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |