Individual
LAURA JANE COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4051 ANTLER DR, GREENWOOD, AR 72936-6804
(479) 651-4805
Mailing address
4051 ANTLER DR, GREENWOOD, AR 72936-6804
(479) 651-4805
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201686706
—
AR
Enumeration date
06/24/2021
Last updated
07/12/2021
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