Individual
MRS. CORIE SUE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
16 12 AVE S, SUITE 103, NAMPA, ID 83704
(208) 461-3720
(208) 461-1787
Mailing address
16 12 AVE S, SUITE 103, NAMPA, ID 83704
(208) 461-3720
(208) 461-1787
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW26741
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010154131
REGENCE
ID
01
—
X6886
BLUE CROSS BLUE SHIELD
ID
Enumeration date
01/02/2007
Last updated
07/08/2007
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