Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 022841 | NY |
Y | 103T00000X | Psychologist | 022841 | NY |
NPI | 1003390998 |
---|---|
Provider Name | Dr. Erin Cook |
First Address | Lake Luzerne, NY 12846-3509 |
Second Address | Clifton Park, NY 12065-3815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |