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Individual

LINDA CAROL COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4804 WESLEY ST, GREENVILLE, TX 75401-5650
(903) 454-0300
Mailing address
400 AIRPORT RD, P O BOX 747, TERRELL, TX 75160
(972) 524-4159

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109531
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8T3322
BCBS NUMBER
TX
Enumeration date
12/04/2006
Last updated
07/09/2007
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