Individual
ANTONIO COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D NCSP
Contact information
Practice address
4822 E PALMETTO ST, FLORENCE, SC 29506-4530
(843) 661-1123
Mailing address
PO BOX 100547, FLORENCE, SC 29502-0547
(843) 661-1123
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
297381
SC
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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