Individual
TRACY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED. S.
Contact information
Practice address
652 ORA AVE SE, ATLANTA, GA 30316-2146
(470) 222-5220
Mailing address
652 ORA AVE SE, ATLANTA, GA 30316-2146
(470) 222-5220
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
657591
GA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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