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NPI Code Detail

MEDICARE: STEPHANIE COOK BCBA

MEDICARE: STEPHANIE COOK BCBA
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
1103K00000XBehavior Analyst1-20-42799FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-20-42799OTHERFLBEHAVIOR ANALYST CERTIFICATION BOARD
2RBT-15-04834OTHERFLBEHAVIOR ANALYST CERTIFICATION BOARD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831631712
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE COOK BCBA
Provider Business Mailing Address
First Line : 40 STATE HIGHWAY 83
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7404
Country : US
Telephone Number : 850-585-9189
Fax Number :
Provider Business Practice Location Address
First Line : 40 STATE HIGHWAY 83
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-7404
Country : US
Telephone Number : 850-585-9189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2016
Last Update Date : 06/26/2020

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Directions to “ STEPHANIE COOK BCBA” Practice Location

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