Organization
COOPER COUNSELING, LLC
Active
Organization
COOPER COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA KINGSTON (ADMINISTRATOR)
(207) 415-0055
Entity
Organization
Contact information
Practice address
251 WOODFORD ST, PORTLAND, ME 04103-5617
(207) 253-9435
(888) 765-8406
Mailing address
75 OCEANSIDE DR, SACO, ME 04072-1765
(207) 253-9435
(888) 765-8406
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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