MEDICARE: CHLOE COOK M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1215385844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE COOK M.S.

Provider Business Mailing Address
First Line	:	8253 CARLTON RD STE 200
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30296-1212
Country	:	US
Telephone Number	:	770-765-5637
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-1646
Country	:	US
Telephone Number	:	770-765-5637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	02/13/2019

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Directions to “ CHLOE COOK M.S.” Practice Location

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