Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 005105 | MO |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 005105 | MO |
NPI | 1649457698 |
---|---|
Provider Name | Mrs. Andria Rachelle Cook |
First Address | Wentzville, MO 63385-2675 |
Second Address | Wentzville, MO 63385-2675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2008 |
Last Update Date | 22/01/2008 |