Individual
MRS. STACY COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
244 CENTRAL ST, WATERTOWN, NY 13601
(315) 405-6257
Mailing address
244 CENTRAL ST, WATERTOWN, NY 13601-2945
(315) 681-6461
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
290336
NY
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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