Individual
DIANE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8 SONNY LN, MANDEVILLE, LA 70448-2267
(985) 373-6953
Mailing address
8 SONNY LANE, MANDEVILLE, LA 70448
(985) 373-6953
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4727
LA
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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