Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 00004461 | WA |
NPI | 1003167768 |
---|---|
Provider Name | Cyndi L Cooley |
First Address | Chehalis, WA 98532-8657 |
Second Address | Tumwater, WA 98512-7356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 20/09/2012 |