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1639832793
KERRY DALE COOPER
LOS ANGELES, CA
NPI
1639832793
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-10-15
Last Update Date
2022-01-03
Business Address
KERRY DALE COOPER
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
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Mailing Address
KERRY DALE COOPER
4847 VISTA DE ORO AVE
VIEW PARK, CA 90043-1610
Phone number: 323-601-7495
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