Individual
DIAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00018324
WA
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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