Healthcare Provider Details

I. General information

NPI: 1053085274
Provider Name (Legal Business Name): RACHAEL A COOK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE A170
GLENDALE AZ
85308-7152
US

IV. Provider business mailing address

3805 E BELL RD STE 5800
PHOENIX AZ
85032-2190
US

V. Phone/Fax

Practice location:
  • Phone: 602-688-6500
  • Fax: 602-867-3144
Mailing address:
  • Phone: 602-688-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: