MEDICARE: ERIN COOK RBT

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	106S00000X	Behavior Technician	RBT-24-393653	FL

General Provider Information

NPI Number	:	1477378032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN COOK RBT

Provider Business Mailing Address
First Line	:	900 FARM CREEK RD APT 360
Second Line	:
City	:	ENTERPRISE
State	:	AL
Zip	:	36330-9075
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W 23RD ST UNIT B20
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3936
Country	:	US
Telephone Number	:	850-348-1057
Fax Number	:

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	06/08/2026

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Directions to “ ERIN COOK RBT” Practice Location

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