Individual
MARY ELLEN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
310 OLD IVY WAY, CHARLOTTESVILLE, VA 22903-4896
(434) 243-6950
(434) 243-6970
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024183234
VA
Other
Enumeration date
06/10/2022
Last updated
11/23/2022
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