Individual
SAMANTHA NICOLE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
301 S MAIN ST, NIXA, MO 65714-5303
(417) 875-5400
Mailing address
274 FAIROAK LN, FORDLAND, MO 65652-8212
(417) 839-2620
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011017429
MO
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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