Individual
MR. THEODORE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
2136 FORD PKWY # 5332, SAINT PAUL, MN 55116-2850
(651) 372-3688
Mailing address
2136 FORD PKWY # 5332, SAINT PAUL, MN 55116-2850
(651) 372-3688
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1545
MN
Other
Enumeration date
06/05/2017
Last updated
10/18/2022
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