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General NPI Number Information
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NPI Number | 1578076766
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Entity Type | Individual
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Provider Name | KELLY E COOK MSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 506 E LANCASTER AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2776
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Country | US
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Telephone | 484-693-0856
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Fax | 484-696-1634
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Provider Business Mailing Address
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Address Line | 212 SILLS LN
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-4963
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Country | US
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Telephone | 516-445-2686
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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