MEDICARE: MRS. JAZMIN COOK

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	103K00000X	Behavior Analyst	1-25-83955	OK

General Provider Information

NPI Number	:	1689393084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAZMIN COOK

Provider Business Mailing Address
First Line	:	1712 S POST RD STE B
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6614
Country	:	US
Telephone Number	:	405-394-4831
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 W MAIN ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-2221
Country	:	US
Telephone Number	:	516-206-8900
Fax Number	:

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

Provider Enumeration Date	:	08/26/2022
Last Update Date	:	11/14/2025

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Directions to “ MRS. JAZMIN COOK ” Practice Location

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