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NPI Code Detail

MEDICARE: AMANDA K COOK M.S.

MEDICARE: AMANDA K COOK M.S.
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
1106H00000XMarriage & Family Therapist2483MN

General Provider Information

NPI Number : 1720341134
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA K COOK M.S.
Provider Business Mailing Address
First Line : 3499 LEXINGTON AVE N STE 100
Second Line :
City : SAINT PAUL
State : MN
Zip : 55126-7058
Country : US
Telephone Number : 651-317-3723
Fax Number : 651-482-9119
Provider Business Practice Location Address
First Line : 3499 LEXINGTON AVE N STE 100
Second Line :
City : SAINT PAUL
State : MN
Zip : 55126-7058
Country : US
Telephone Number : 651-317-3723
Fax Number : 651-482-9119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2012
Last Update Date : 11/08/2021

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Directions to “ AMANDA K COOK M.S.” Practice Location

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