Individual
LACEY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3105 INDEPENDENCE ST STE B, CAPE GIRARDEAU, MO 63703-5042
(573) 334-4477
(573) 334-0622
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
(636) 946-0991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018033383
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018033383
MO DIVISION OF PROFESSIONAL REGISTRY
MO
Enumeration date
01/31/2020
Last updated
01/31/2020
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