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NPI Code Detail

MEDICARE: CHARLESTINE COOPER

MEDICARE: CHARLESTINE COOPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker9475LA

General Provider Information

NPI Number : 1356921001
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLESTINE COOPER
Provider Business Mailing Address
First Line : 154 MILL ST
Second Line :
City : GARYVILLE
State : LA
Zip : 70051-3506
Country : US
Telephone Number : 985-233-6193
Fax Number :
Provider Business Practice Location Address
First Line : 154 MILL ST
Second Line :
City : GARYVILLE
State : LA
Zip : 70051-3506
Country : US
Telephone Number : 985-233-6193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2021
Last Update Date : 04/08/2021

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Directions to “ CHARLESTINE COOPER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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