Basic Information
| Provider Information | |||||||||
| NPI: | 1003150632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | ALLEGRA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16507 NORTHCROSS DR STE A | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | HUNTERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280785082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043058026 | ||||||||
| FaxNumber: | 4256962262 | ||||||||
| Practice Location | |||||||||
| Address1: | 16507 NORTHCROSS DR STE A | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | HUNTERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280785082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043058026 | ||||||||
| FaxNumber: | 4256962262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2012 | ||||||||
| LastUpdateDate: | 06/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | A9259 | NC | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.