Individual
JOE B COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
306 WESTWOOD AVE, JACKSON, TN 38301-4324
(731) 217-0276
Mailing address
306 WESTWOOD AVE, JACKSON, TN 38301-4324
(731) 217-0276
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
947
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1505295
—
TN
01
—
4158899
BCBS
TN
Enumeration date
04/18/2007
Last updated
01/12/2009
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