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Individual
MR. JAMES KOO
Active
Individual
MR. JAMES KOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, RAS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
K1202230953
CA
1041C0700X
Clinical Social Worker
4962
OR
Other
Enumeration date
10/08/2012
Last updated
11/15/2012
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