MEDICARE: KAILEE COOK

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	106E00000X	Assistant Behavior Analyst	0-26-17168	FL

General Provider Information

NPI Number	:	1578314597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAILEE COOK

Provider Business Mailing Address
First Line	:	4050 ROCKY CIR APT A223
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4935
Country	:	US
Telephone Number	:	850-933-0485
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 ROCKY CIR APT A223
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4935
Country	:	US
Telephone Number	:	850-933-0485
Fax Number	:

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

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	06/08/2026

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Directions to “ KAILEE COOK ” Practice Location

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