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Individual

LAURA THERESE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPSS

Contact information

Practice address
207 COMMERCE AVENUE, CHESTERFIELD, SC 29709
(843) 623-2229
(843) 623-2553
Mailing address
PO BOX 918, BENNETTSVILLE, SC 29512-0918
(843) 454-0841

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
405127
SC
Enumeration date
05/03/2007
Last updated
07/08/2007
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