Individual
MARY E COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-9355
Mailing address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-9355
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015040227
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015040227
DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
07/20/2012
Last updated
07/18/2024
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