Individual
CRYSTAL COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20300 SUPERIOR RD, TAYLOR, MI 48180-6331
(734) 785-7700
Mailing address
5065 GATESHEAD ST, GROSSE POINTE FARMS, MI 48236-2170
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
6801098399
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205299237
—
MI
Enumeration date
03/29/2016
Last updated
09/20/2022
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