Individual
MISS IRAJUAN L COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 WICHERS DR STE 206, MARRERO, LA 70072-3054
(504) 710-9690
Mailing address
4700 WICHERS DR STE 206, MARRERO, LA 70072-3054
(504) 645-5506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
14443
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
14443
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04091982
—
LA
05
—
08041955
—
LA
Enumeration date
07/26/2018
Last updated
06/27/2023
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