Individual
CHRISTAL JUNE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
823 PARKCENTRE WAY, NAMPA, ID 83651-1783
(208) 475-5065
(208) 463-0972
Mailing address
11510 W 1ST ST, STAR, ID 83669-5267
(208) 921-9931
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LMSW-28189
ID
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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