Individual
CASSIDY COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
Mailing address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA-187783
OH
101YM0800X
Mental Health Counselor
Primary
C2405804-TRNE
OH
390200000X
Student in an Organized Health Care Education/Training Program
C2405804-TRNE
OH
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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