Healthcare Provider Details

I. General information

NPI: 1790997831
Provider Name (Legal Business Name): RACHEL LAURA COOK LAC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1961 S TELEGRAPH RD
BLOOMFIELD HILLS MI
48302-0246
US

IV. Provider business mailing address

PO BOX 670884
DETROIT MI
48267-0884
US

V. Phone/Fax

Practice location:
  • Phone: 248-319-6190
  • Fax: 248-607-6362
Mailing address:
  • Phone: 800-436-7936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number5402000340
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198000618
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: