Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0810002691 | VA |
Y | 103G00000X | Clinical Psychologist | 0810002691 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810002691 | VA |
N | 103TF0000X | Family Psychologist | 0810002691 | VA |
N | 103TH0004X | Health Psychologist | 0810002691 | VA |
N | 103TP2701X | Group Psychotherapist | 0810002691 | VA |
N | 103TR0400X | Rehabilitation Psychologist | 0810002691 | VA |
NPI | 1770811721 |
---|---|
Provider Name | Andrew Cook |
First Address | Temple, TX 76504-7451 |
Second Address | Temple, TX 76504-7451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 12/02/2015 |