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General NPI Number Information
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NPI Number | 1871707869
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Entity Type | Individual
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Provider Name | SUSAN L. COOK M.A., MFT
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1891 E ROSEVILLE PKWY SUITE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-7974
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Country | US
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Telephone | 916-789-7082
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Fax | 916-797-8840
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Provider Business Mailing Address
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Address Line | 1891 EAST ROSEVILLE PARKWAY SUITE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-7974
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Country | US
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Telephone | 916-789-7082
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Fax | 916-797-8840
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 32401
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License Number State | CA
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