Individual
MR. ROBERT LEN COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, BAC, CADC1
Contact information
Practice address
3325 HAROLD DR NE, SALEM, OR 97305-1339
(503) 363-2021
Mailing address
5695 KINGS VALLEY HWY, DALLAS, OR 97338-9437
(503) 420-9671
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
981004
ACCBO
OR
Enumeration date
02/02/2007
Last updated
07/08/2007
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