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General NPI Number Information
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NPI Number | 1134515224
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Entity Type | Individual
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Provider Name | JOHN LUNSFORD COOLEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1901 UNIVERSITY AVE RM 103
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City | LUBBOCK
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State | TX
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Zip | 79410-1544
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Country | US
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Telephone | 806-834-5194
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Fax |
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Provider Business Mailing Address
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Address Line | BOX 42051
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City | LUBBOCK
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State | TX
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Zip | 79409-2051
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Country | US
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Telephone | 806-834-5194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 39946
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License Number State | TX
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