Individual
ANN R COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, LADC
Contact information
Practice address
7501 80TH ST S STE 108, COTTAGE GROVE, MN 55016-4121
(612) 564-8073
(651) 925-0453
Mailing address
1636 HEWITT AVE, SAINT PAUL, MN 55104-1236
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304497
MN
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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