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Individual

ANNISCHA E COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, MSW

Contact information

Practice address
4213 VERA CRUZ AVE N, ROBBINSDALE, MN 55422-1210
(763) 536-9013
(763) 536-9013
Mailing address
4213 VERA CRUZ AVE N, ROBBINSDALE, MN 55422-1210
(763) 536-9013
(763) 536-9013

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09068
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00135511
METROPOLITAN HEALTH PLAN
MN
01
151040
UCARE PROVIDER ID
MN
01
17F09CO
BLUE CROSS-BLUE SHIELD ID
MN
01
17F10CO
BLUE CROSS-BLUE SHIELD ID
MN
01
62-75573
MEDICA
MN
01
990991033373
PREFERRED ONE
MN
Enumeration date
12/04/2006
Last updated
07/09/2007
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