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Individual

TANYA ILENE COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S

Contact information

Practice address
30 CENTRAL AVE, WELCH, WV 24801-2008
(304) 436-8441
Mailing address
1062 AIRPORT RD, WELCH, WV 24801-2710
(304) 549-8100

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
21035
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9201036000
WV
Enumeration date
02/06/2007
Last updated
07/09/2007
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