Individual
MICHAEL DEAN COOKSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
230 W 10600 S STE 1700, SANDY, UT 84070-4144
(845) 329-0438
Mailing address
CMR 411 BOX 6604, APO, AE 09112-0067
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12371389-3501
UT
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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