Individual
MS. ILENE L COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
2790 SANDY PLAINS RD STE 203, MARIETTA, GA 30066-4377
(770) 833-7318
(770) 833-7318
Mailing address
3043 S MEADOW CT, PATIENT ACCOUNTING, MARIETTA, GA 30062-5162
(770) 833-7318
(770) 552-6783
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003312
GA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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