Healthcare Provider Details

I. General information

NPI: 1851922124
Provider Name (Legal Business Name): AYLA COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 01/27/2020
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 E 12TH AVE
DENVER CO
80220-2415
US

IV. Provider business mailing address

4455 E 12TH AVE # 80220
DENVER CO
80220-2415
US

V. Phone/Fax

Practice location:
  • Phone: 402-699-5746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: