Individual
ANGELLA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1427 VINE ST, PHILADELPHIA, PA 19102-1031
(215) 762-2530
Mailing address
5774 STEWART ST, PHILADELPHIA, PA 19131-3420
(267) 349-7414
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21734
AGENCY ID
PA
Enumeration date
05/10/2021
Last updated
05/10/2021
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