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General NPI Number Information
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NPI Number | 1679076020
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Entity Type | Individual
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Provider Name | AUBRIE JO COOK OTR
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Gender | Female
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 515 GREENE DR
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City | GREENVILLE
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State | KY
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Zip | 42345-1409
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Country | US
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Telephone | 270-338-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 8410 NEWBURY RD
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City | EVANSVILLE
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State | IN
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Zip | 47725-7446
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Country | US
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Telephone | 812-550-2311
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 241024
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License Number State | KY
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