Doctor Name: | MR. RICHARD N. COCKER |
NPI Number: | 1063578441 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LP |
License Number: | LP0073 |
Business Practice Address: | 111 Market St Suite 3a Winona, MN - 559875532 |
Business Phone Number: | 5074543900 |
Business Fax Number: | 5074527459 |
Mailing Address: | 111 Market St, Suite 3a WINONA |
State: | MN |
Postal Code: | 559875532 |
Phone Number: | 5074543900 |
Fax Number: | 5074527459 |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TP2701X |
License Number: | LP0073 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Group Psychotherapy |
Taxonomy Definition: |