Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013152248 |
---|---|
Provider Name | Ms. Patricia Ann Cook |
First Address | Freeport, IL 61032-4631 |
Second Address | Freeport, IL 61032-4631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 02/12/2008 |