Individual
MADONNA COOPER POOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS., LCADC, LCPC
Contact information
Practice address
3783 PLEASANT VALLEY RD, OAKLAND, MD 21550-5609
(301) 616-7469
Mailing address
331 EARL HAUSER RD, OAKLAND, MD 21550-2418
(301) 334-0565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA201
MD
101YP2500X
Professional Counselor
60402
NC
101YP2500X
Professional Counselor
Primary
LC1504
MD
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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