Individual
ANDREA DANIELLE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HC 64 BOX 4683, MARBLE HILL, MO 63764-9408
(573) 238-1300
(573) 238-1302
Mailing address
HC 64 BOX 4683, MARBLE HILL, MO 63764-9408
(573) 238-1300
(573) 238-1302
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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