Individual
TINA WYNN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
243 REXFORD DR, MOORE, SC 29369-9477
(864) 580-1327
Mailing address
243 REXFORD DR, MOORE, SC 29369-9477
(864) 580-1327
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
SC
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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