Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 67 | NC |
NPI | 1336331560 |
---|---|
Provider Name | Dr. Robert Lawson Cooke |
First Address | Raleigh, NC 27609-4389 |
Second Address | Raleigh, NC 27609-4389 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2007 |
Last Update Date | 01/12/2016 |