Individual
TAMARA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
514 CHICKASAWBA ST, BLYTHEVILLE, AR 72315-2722
(870) 824-2268
(870) 824-2269
Mailing address
514 CHICKASAWBA ST, BLYTHEVILLE, AR 72315-2722
(870) 824-2268
(870) 824-2269
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6627-M
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183587795
—
AR
Enumeration date
03/19/2013
Last updated
08/02/2019
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