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NPI Code Detail

MEDICARE: CINELLA COOPER

MEDICARE: CINELLA 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1528497765
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINELLA COOPER
Provider Business Mailing Address
First Line : 198 S MACARTHUR DR
Second Line :
City : CAMILLA
State : GA
Zip : 31730-6370
Country : US
Telephone Number : 229-336-2247
Fax Number : 229-336-8009
Provider Business Practice Location Address
First Line : 198 S MACARTHUR DR
Second Line :
City : CAMILLA
State : GA
Zip : 31730-6370
Country : US
Telephone Number : 229-336-2247
Fax Number : 229-336-8009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2013
Last Update Date : 11/07/2013

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1619306099 — ESTHER BRADSHAW PARAPROFESSIONAL
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Practice Location Address:
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1275962557 — CATHY SCOTT
Practice Location Address:
198 S MACARTHUR DR
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31730-6370
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Practice Fax: 229-336-8009

Directions to “ CINELLA COOPER ” Practice Location

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