Individual
TINA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 586-4201
(918) 586-4293
Mailing address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 586-4201
(918) 586-4293
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3422
OK
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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