Individual
MS. BETTY JO COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
801 S HERMON RD, WASILLA, AK 99654-7311
(907) 631-3971
(907) 631-4085
Mailing address
801 S HERMON RD, WASILLA, AK 99654-7311
(907) 631-3971
(907) 631-4085
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
100689
AK
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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