| NPI | 1730735028 | 
|---|---|
| Former Name | MANDY LYNN COOK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 24-06-11159) | 
| 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHA-II-000264) | |
| 171M00000X Case Manager/Care Coordinator (Licence: OK 316485) | |
| 175T00000X Peer Specialist (Licence: OR 24CRM3244) | |
| Enumeration Date | 2019-08-13 | 
| Last Update Date | 2025-01-28 |