Individual
TYLER COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
148 E 50 S STE 2, MALAD CITY, ID 83252-1368
(208) 609-3010
Mailing address
292 N 300 W, MALAD CITY, ID 83252-1130
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-45185
ID
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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