Individual
MR. KENNETH JOHN COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 VIRGINIA BEACH BLVD, 440, VIRGINIA BEACH, VA 23452-4445
(757) 606-0015
Mailing address
3500 VIRGINIA BEACH BLVD, 440, VIRGINIA BEACH, VA 23452-4445
(757) 606-0015
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004849
VA
Other
Enumeration date
06/18/2010
Last updated
05/16/2014
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