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Individual
MRS. PATTY LORRAINE COOK
Active
Individual
MRS. PATTY LORRAINE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
006969
IA
1041C0700X
Clinical Social Worker
Primary
149014607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208833012
MEDICARE PTAN
IL
Enumeration date
08/28/2010
Last updated
11/14/2012
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