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General NPI Number Information
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NPI Number | 1427976208
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Entity Type | Individual
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Provider Name | BETHANY COOK RBT
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Gender | Female
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 1012 GA HIGHWAY 247 S
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City | KATHLEEN
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State | GA
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Zip | 31047-2349
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Country | US
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Telephone | 478-732-1315
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Fax |
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Provider Business Mailing Address
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Address Line | 215 GLENEAGLE DR
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City | BYRON
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State | GA
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Zip | 31008-3810
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Country | US
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Telephone | 478-732-1315
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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 | RBT-26-2828021
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License Number State | GA
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