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Individual

MRS. MARIALYCE D COOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
7209 CREEDMOOR RD, SUITE 101, RALEIGH, NC 27613-1625
(919) 844-1100
(919) 844-1102
Mailing address
129 LIGHT FALLS DR, WAKE FOREST, NC 27587-5753
(919) 529-0950

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2209
NC

Other

Enumeration date
07/01/2008
Last updated
07/01/2008
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