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General NPI Number Information
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NPI Number | 1982729117
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Entity Type | Individual
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Provider Name | MANDY M COOK RD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 50 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20422-0001
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Country | US
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Telephone | 202-745-8190
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Fax |
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Provider Business Mailing Address
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Address Line | 1226 ELM GROVE CIR
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City | SILVER SPRING
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State | MD
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Zip | 20905-7018
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Country | US
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Telephone | 616-916-4991
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 960672
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License Number State | IL
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