Most Relevant Information
Provider Data
| NPI Number: | 1003476466 |
| Provider Name: | SHAQUILLA N COOPER DSW, TCM, LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/18/2019 |
| Last Updated: | 10/01/2024 |
Provider Practice Location
1828 BOLLING AVE
LOUISVILLE
KY
402101908
Practice Location Phone/Fax
| Phone: | 5025367245 |
| Fax: | 5029635135 |
Provider Mailing Location
1828 BOLLING AVE
LOUISVILLE
KY
402101908
Provider Mailing Phone/Fax
| Phone: | 5026189205 |
| Fax: | 5029635135 |