MEDICARE: AMBERNECIA COOKSEY

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	225X00000X	Occupational Therapist	0119010007	VA

General Provider Information

NPI Number	:	1669192787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBERNECIA COOKSEY

Provider Business Mailing Address
First Line	:	210 N LEE ST STE 300
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2659
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 N LEE ST FL 3
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2631
Country	:	US
Telephone Number	:	985-507-6763
Fax Number	:

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

Provider Enumeration Date	:	08/30/2022
Last Update Date	:	02/20/2024

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Directions to “ AMBERNECIA COOKSEY ” Practice Location

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