Individual
DENISE D COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSATP
Contact information
Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0718000196
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945255
—
VA
Enumeration date
06/05/2009
Last updated
06/05/2009
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