Healthcare Provider Details

I. General information

NPI: 1568126324
Provider Name (Legal Business Name): BRITTANY COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3979 E 54TH ST
NEWBURGH HEIGHTS OH
44105-4865
US

IV. Provider business mailing address

3979 E 54TH ST
NEWBURGH HEIGHTS OH
44105-4865
US

V. Phone/Fax

Practice location:
  • Phone: 585-360-6518
  • Fax:
Mailing address:
  • Phone: 585-360-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: