Provider Demographics
NPI:1154718351
Name:COOLEY, ORA CADESIA
Entity type:Individual
Prefix:
First Name:ORA
Middle Name:CADESIA
Last Name:COOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 PARKS AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-6167
Mailing Address - Country:US
Mailing Address - Phone:619-316-0490
Mailing Address - Fax:
Practice Address - Street 1:4431 PARKS AVE APT 6
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-6167
Practice Address - Country:US
Practice Address - Phone:619-316-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-25
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool