Individual
MS. TEAWANNA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWR QMHP-A/C M.ED.
Contact information
Practice address
900 COMMONWEALTH PL STE 200, VIRGINIA BEACH, VA 23464-4530
(757) 788-3033
Mailing address
900 COMMONWEALTH PL STE 200, 392, VIRGINIA BEACH, VA 23464-4530
(757) 788-3033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0732009862
VA
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
853474580
IRS
VA
Enumeration date
05/04/2011
Last updated
02/09/2024
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