| NPI | 1730735028 |
|---|---|
| Former Name | MANDY LYNN COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 24-06-11159) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHA-II-000264) |
| 171M00000X Case Manager/Care Coordinator (Licence: OK 316485) | |
| 175T00000X Peer Specialist (Licence: OR THW000111552) | |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2024-08-28 |