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NPI 1225726995

NPI 1225726995 : SYDNEY COOK : HUTCHINSON, KS

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General NPI Number Information
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    NPI Number           |    1225726995
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    Entity Type          |    Individual 
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    Provider Name        |    SYDNEY COOK
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/28/2023
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    Last Update Date     |    04/28/2023
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Provider Practice Location Address
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    Address Line         |    6110 N MONROE ST 
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    City                 |    HUTCHINSON
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    State                |    KS
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    Zip                  |    67502-3262
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    Country              |    US
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    Telephone            |    620-931-0412
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4301 W 24TH PL 
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    City                 |    LAWRENCE
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    State                |    KS
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    Zip                  |    66047-2449
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    106S00000X
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    License Number State |    KS
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