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General NPI Number Information
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NPI Number | 1295543965
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Entity Type | Individual
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Provider Name | ZAYAH M COOK
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Gender |
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 5307 S KNOLLCREST ST APT A
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City | MURRAY
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State | UT
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Zip | 84107-6320
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Country | US
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Telephone | 208-901-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 2025 S 50 W
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City | BOUNTIFUL
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State | UT
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Zip | 84010-5559
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Country | US
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Telephone | 801-548-3091
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Fax | 801-992-7150
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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 |
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License Number State |
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