| NPI | 1255948519 |
|---|---|
| Professional Name | JAY RASHAD COPPEDGE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 167G00000X Licensed Psychiatric Technician | |
| 175T00000X Peer Specialist | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |