Individual
STACEY COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 774-8533
Mailing address
1705 BENNING RD NE APT C42, WASHINGTON, DC 20002-7236
(202) 774-8533
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/09/2023
Last updated
06/12/2023
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