Individual
MRS. PHYLLIS T. COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD, CCDC, ICADC
Contact information
Practice address
2823 OCEAN GTWY, CAMBRIDGE, MD 21613-3403
(410) 221-6343
(410) 221-6342
Mailing address
8715 SHADOW LN, DELMAR, MD 21875-2551
(410) 221-6343
(410) 221-6342
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC0191
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC0191
CERTIFIED ADDICTION COUNS
MD
Enumeration date
12/05/2006
Last updated
07/08/2007
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