Individual
BETHANY HEATHER COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1149 SULLIVAN ST, ELMIRA, NY 14901-1670
(607) 733-7661
Mailing address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103834
NY
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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