Individual
MRS. LISA JEANNE COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1811 SKYLINE RD, LAFAYETTE, IN 47905-5591
(765) 404-6430
Mailing address
1811 SKYLINE RD, LAFAYETTE, IN 47905-5591
(765) 404-6430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004014A
IN
1041S0200X
School Social Worker
1448119
IN
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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