Provider Demographics
NPI:1518776053
Name:COOPER, DARCY (RBT)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:COOPER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 VEVAU ST APT 324
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1664
Mailing Address - Country:US
Mailing Address - Phone:443-365-4516
Mailing Address - Fax:
Practice Address - Street 1:1367 SOUTH KIHEI RD
Practice Address - Street 2:APT 3-102
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753
Practice Address - Country:US
Practice Address - Phone:443-365-4516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician