Healthcare Provider Details

I. General information

NPI: 1194598086
Provider Name (Legal Business Name): KRISTIN COOK MS, BSL, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 N CENTER AVE
SOMERSET PA
15501-7019
US

IV. Provider business mailing address

473 EDWARD ST
JOHNSTOWN PA
15905-3162
US

V. Phone/Fax

Practice location:
  • Phone: 814-445-1717
  • Fax:
Mailing address:
  • Phone: 814-659-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-58460
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: