Individual
GARY ALLEN COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II QMHA
Contact information
Practice address
185 S.W. ACADEMY ST., DALLAS, OR 97338-1996
(503) 585-3012
(503) 585-3012
Mailing address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 585-3012
(503) 375-9727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
03-11-08
OR
Other
Enumeration date
02/06/2008
Last updated
10/24/2024
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