Healthcare Provider Details

I. General information

NPI: 1477378032
Provider Name (Legal Business Name): ERIN COOK RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 23RD ST UNIT B20
PANAMA CITY FL
32405-3936
US

IV. Provider business mailing address

900 FARM CREEK RD APT 360
ENTERPRISE AL
36330-9075
US

V. Phone/Fax

Practice location:
  • Phone: 850-348-1057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-393653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: