Doctor Name: | KERSTIN LYNN COOLEY |
NPI Number: | 1285971713 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 10286 |
Business Practice Address: | 41385 Us Highway 71 Windom, MN - 561013197 |
Business Phone Number: | 5078312090 |
Business Fax Number: | 5078310185 |
Mailing Address: | 41385 Us Highway 71, WINDOM |
State: | MN |
Postal Code: | 561013197 |
Phone Number: | 5078312090 |
Fax Number: | 5078310185 |
NPI Enumeration Date: | 01/03/2013 |
NPI Last Update Date: | 01/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 10286 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |