Doctor Name: | RANDY DALE COOK |
NPI Number: | 1992024855 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BS EDUCATION |
License Number: | |
Business Practice Address: | 1000 Meadow Lane Howe, OK - 74940 |
Business Phone Number: | 9186582189 |
Business Fax Number: | |
Mailing Address: | Po Box 143, FANSHAWE |
State: | OK |
Postal Code: | 749350143 |
Phone Number: | 9186355547 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2010 |
NPI Last Update Date: | 05/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |