Individual
MATASHA VIRDORA COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3236 W 64TH ST FL 2, CHICAGO, IL 60629-2714
(312) 519-9328
Mailing address
3236 W 64TH ST FL 2, CHICAGO, IL 60629-2714
(312) 519-9328
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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