Individual
MR. GARY TAYLOR COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, CADC-I
Contact information
Practice address
3325 HAROLD DR NE, SALEM, OR 97305-1339
(503) 399-5597
(503) 316-9740
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 399-5597
(503) 316-9740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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