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Individual
JENNIFER MARIE COOK
Active
Individual
JENNIFER MARIE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, MA OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5469
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104539
MINNESOTA LICENSE
MN
01
—
5469
WISCONSIN LICENSE
WI
Enumeration date
03/25/2014
Last updated
03/25/2014
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