Individual
TYRA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2605 BETTY ST, SHREVEPORT, LA 71108-5553
(318) 216-3748
Mailing address
2605 BETTY ST, SHREVEPORT, LA 71108-5553
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8345
LA
Other
Enumeration date
08/03/2017
Last updated
11/11/2022
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