NPI 1508014077

Betty Jo Cooley, LPN

Practitioner Physical Disabilities Residential Treatment Facility Wasilla, AK

Practice location

Address: 801 S Hermon Rd, Wasilla, AK 99654-7311
Phone: (907) 631-3971
Fax: (907) 631-4085

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 100689 (AK)

Other Residential Treatment Facility, Physical Disabilities providers in Alaska →

Registry record

NPI: 1508014077
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Sep 2008
Record last updated: 8 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.