| NPI | 1861867160 |
|---|---|
| Former Name | KELLY MARIE COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CO 0175363) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |