Individual
MR. DARYL RAY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2330 MARINA DR, KLAMATH FALLS, OR 97601
(541) 883-3471
(541) 883-3524
Mailing address
2330 MARINA DRIVE, KLAMATH FALLS, OR 97601
(541) 891-4402
(541) 883-3524
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L411
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026825000
BCBS PROVIDER #
OR
05
—
090450
—
OR
Enumeration date
04/16/2007
Last updated
11/16/2016
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