Individual
STACEY MARIE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
110 S CHERRY ST STE 200, OLATHE, KS 66061-3441
(913) 378-6312
Mailing address
5145 LONG DR, SHAWNEE, KS 66216-1455
(913) 378-6312
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8330
KS
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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