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General NPI Number Information
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NPI Number | 1649815143
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Entity Type | Individual
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Provider Name | ELIZABETH COOPER
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 610 UPTOWN BLVD STE 4000
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City | CEDAR HILL
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State | TX
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Zip | 75104-3534
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Country | US
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Telephone | 682-348-4088
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Fax |
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Provider Business Mailing Address
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Address Line | 824 GLENWICK CT
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City | BURLESON
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State | TX
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Zip | 76028-7413
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Country | US
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Telephone | 940-232-6772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86286
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License Number State | TX
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