Provider Demographics
NPI:1992270474
Name:COOLEY, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
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 1:30321 WINGFOOT DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-8862
Mailing Address - Country:US
Mailing Address - Phone:425-301-2695
Mailing Address - Fax:
Practice Address - Street 1:30321 WINGFOOT DR
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-8862
Practice Address - Country:US
Practice Address - Phone:425-301-2695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst