Individual
IVY MARIAH COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6871 W CHARLESTON BLVD, LAS VEGAS, NV 89117-1600
(702) 489-2117
Mailing address
5415 MOLISE CT, LAS VEGAS, NV 89141-7101
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CP5844
NV
Other
Enumeration date
06/28/2021
Last updated
01/22/2025
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