Provider Demographics
NPI:1487484077
Name:COOPER, ASHLEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 WESTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1933
Mailing Address - Country:US
Mailing Address - Phone:585-210-0785
Mailing Address - Fax:
Practice Address - Street 1:2301 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1933
Practice Address - Country:US
Practice Address - Phone:585-210-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool