Individual
MR. KEVIN MARCELL COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLADC
Contact information
Practice address
1941 S 42ND ST STE 412, OMAHA, NE 68105-2944
(402) 991-8101
(402) 991-8103
Mailing address
1941 S 42ND ST STE 412, OMAHA, NE 68105-2944
(402) 991-8101
(402) 991-8103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-882
NE
Other
Enumeration date
12/17/2010
Last updated
12/21/2010
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