Individual
REBECCA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Mailing address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1375
ID
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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