Healthcare Provider Details

I. General information

NPI: 1245673516
Provider Name (Legal Business Name): HARMONY JOY COOK-THERIAULT MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. HARMONY JOY COOK

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 CAUTHEN CREEK DR
MELBOURNE FL
32934-2933
US

IV. Provider business mailing address

3132 CAUTHEN CREEK DR
MELBOURNE FL
32934-2933
US

V. Phone/Fax

Practice location:
  • Phone: 321-987-6389
  • Fax:
Mailing address:
  • Phone: 321-987-6389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCRPSV.800
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA105821
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: