Individual
JENNIFER ADELLA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHC, NCC
Contact information
Practice address
416 MCCULLOUGH DR STE 150A, CHARLOTTE, NC 28262-4391
(980) 292-1129
Mailing address
416 MCCULLOUGH DR STE 150A, CHARLOTTE, NC 28262-4391
(980) 292-1129
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13204
NC
Other
Enumeration date
09/07/2017
Last updated
11/29/2022
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