Individual
JENNIFER LIANE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2320 RIO GRANDE BLVD. SE, SUITE D, RIO RANCHO, NM 87124
(505) 219-1125
Mailing address
2320 RIO GRANDE BLVD. SE, SUITE D, RIO RANCHO, NM 87124
(505) 219-1125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0180961
NM
101YS0200X
School Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59652314
—
NM
Enumeration date
09/11/2007
Last updated
02/06/2020
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