Individual
MR. CULLEN CONRAD COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CFY-SLP
Contact information
Practice address
625 PINEY FOREST RD STE 407, DANVILLE, VA 24540-2870
(434) 799-7732
Mailing address
206 MOUNT VERNON AVE, APT A, DANVILLE, VA 24541-2815
(803) 646-2086
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008324
VA
Other
Enumeration date
08/21/2016
Last updated
08/21/2016
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