Individual
MR. LARRY COPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CADC
Contact information
Practice address
2148 VADALABENE DR, MARYVILLE, IL 62062-5632
(618) 288-3100
(618) 288-2278
Mailing address
2148 VADALABENE DR, MARYVILLE, IL 62062-5632
(618) 288-3100
(618) 288-2278
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20037
IL
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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