Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | A9259 | NC |
NPI | 1003150632 |
---|---|
Provider Name | Allegra Cooper |
First Address | Huntersville, NC 28078-5082 |
Second Address | Huntersville, NC 28078-5082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2012 |
Last Update Date | 29/06/2016 |