Provider Information for 1255652624
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Mrs. GLORIA ANNETTE COOPER MEd/LPC
Other Names:Professional Name:Mrs. GLORIA ANNETTER COOPER MEd.LPCSex: Female
NPI: 1255652624
Last Updated: 2024-01-24
Certification Date: 2024-01-24
Certification Date: 2024-01-24
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1255652624 | ||||||||||||
| Enumeration Date | 2010-06-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 5435 SUNBURY DR BEAUMONT, TX 77707-1941 United States Phone: 409-225-5292 | Fax: | ||||||||||||
| Primary Practice Address | 2750 S 8TH ST BEAUMONT, TX 77701-7719 United States Phone: 409-839-1000 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 5435 SUNBURY DR | ||||||||||||
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