Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 0469 | MS |
Y | 101YP2500X | Professional Counselor | 65790 | TX |
NPI | 1003024860 |
---|---|
Provider Name | Dr. Terry W Cook |
First Address | Georgetown, TX 78633-5398 |
Second Address | Georgetown, TX 78633-5398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 24/01/2011 |