Individual
SHAQUILLA N COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DSW, TCM, LCSW
Contact information
Practice address
1828 BOLLING AVE, LOUISVILLE, KY 40210-1908
(502) 536-7245
(502) 963-5135
Mailing address
1828 BOLLING AVE, LOUISVILLE, KY 40210-1908
(502) 618-9205
(502) 963-5135
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
254214
KY
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
10/01/2024
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