Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 2020007796 | MO |
NPI | 1003444068 |
---|---|
Provider Name | Savanna Cook |
First Address | Overland, MO 63114-4849 |
Second Address | Overland, MO 63114-4849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2020 |
Last Update Date | 27/03/2020 |