MEDICARE: KIRSTEN COOK M.A.

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
1	101YP2500X	Professional Counselor	LPC-0879	AZ

General Provider Information

NPI Number	:	1508039090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN COOK M.A.

Provider Business Mailing Address
First Line	:	3939 N MAGNETITE LN
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-9167
Country	:	US
Telephone Number	:	520-908-4371
Fax Number	:	520-908-4301

Provider Business Practice Location Address
First Line	:	3939 N MAGNETITE LN
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-9167
Country	:	US
Telephone Number	:	520-908-4371
Fax Number	:	520-908-4301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	04/07/2008

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Directions to “ KIRSTEN COOK M.A.” Practice Location

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