Individual
CHARLESTINE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
154 MILL ST, GARYVILLE, LA 70051-3506
(985) 233-6193
Mailing address
154 MILL ST, GARYVILLE, LA 70051-3506
(985) 233-6193
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9475
LA
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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