Organization
COOK BEHAVIORAL HEALTH CLINIC, PC
Active
Other names
Cook Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JASON T COOK PSYD (OWNER)
(260) 483-2400
Entity
Organization
Contact information
Practice address
7230 ENGLE RD STE 304, FORT WAYNE, IN 46804-2209
(260) 483-2400
(260) 960-9361
Mailing address
7230 ENGLE RD STE 304, FORT WAYNE, IN 46804-2209
(260) 483-2400
(260) 960-9361
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041587A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200290630
—
IN
Enumeration date
06/04/2008
Last updated
06/11/2019
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