Individual
MICO BRENITTA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10105 PLANK RD STE 5, CLINTON, LA 70722-3707
(225) 605-5026
Mailing address
10105 PLANK RD STE A, CLINTON, LA 70722-3707
(225) 605-5026
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
AN529595
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/17/2021
Last updated
09/07/2021
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