Individual
MS. ELICIA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3605 W PIONEER PKWY STE C, PANTEGO, TX 76013-4500
(817) 277-8870
Mailing address
PO BOX 151121, ARLINGTON, TX 76015-7121
(817) 296-7541
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-14-5946
TX
103K00000X
Behavior Analyst
1-15-19081
TX
Other
Enumeration date
01/24/2015
Last updated
07/14/2015
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