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NPI Code Detail

MEDICARE: PEGGY COOK PH. D.

MEDICARE: PEGGY COOK PH. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist5519OH

General Provider Information

NPI Number : 1477593226
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY COOK PH. D.
Provider Business Mailing Address
First Line : 4624 SAWMILL ROAD
Second Line :
City : COLUMBUS
State : OH
Zip : 43220
Country : US
Telephone Number : 614-459-4490
Fax Number : 614-457-3656
Provider Business Practice Location Address
First Line : 4624 SAWMILL RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2247
Country : US
Telephone Number : 614-459-4490
Fax Number : 614-457-3656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 10/15/2009

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