Individual
JANE COOPER-HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2014023105
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017003781
LCSW
MO
Enumeration date
01/20/2017
Last updated
02/13/2017
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