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1053584938
WANETA DESHON WILLIS-COOPER
HAMMOND, IN
NPI
1053584938
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2008-04-10
Last Update Date
2015-04-06
Business Address
Ms. WANETA DESHON WILLIS-COOPER
6116 MARSHALL AVE
HAMMOND, IN 46323-1054
Phone number: 219-852-0998
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Mailing Address
Ms. WANETA DESHON WILLIS-COOPER
6116 MARSHALL AVE
HAMMOND, IN 46323-1054
Phone number: 219-852-0998
Copy
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