Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 1084 | SC |
N | 103TC0700X | Clinical Psychologist | 1084 | SC |
Y | 103G00000X | Clinical Psychologist | SC 1084 | SC |
Y | 103TC0700X | Clinical Psychologist | SC 1084 | SC |
NPI | 1013153170 |
---|---|
Provider Name | Dr. Virginia Galloway Cooper |
First Address | Columbia, SC 29205 |
Second Address | Columbia, SC 29205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2008 |
Last Update Date | 04/11/2021 |