Most Relevant Information
Provider Data
| NPI Number: | 1003396052 |
| Provider Name: | MARSHEA COOPER |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2018 |
| Last Updated: | 08/20/2018 |
Provider Practice Location
460 BRIARWOOD DR STE 510
JACKSON
MS
392063057
Practice Location Phone/Fax
| Phone: | 6019564816 |
| Fax: | 6019564817 |
Provider Mailing Location
PO BOX 13509
JACKSON
MS
392363509
Provider Mailing Phone/Fax
| Phone: | 6019564816 |
| Fax: | 6019564817 |