Individual
MRS. LYNDA MANN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
405 NC 65, WENTWORTH, NC 27375-0355
(336) 342-8316
(336) 342-8352
Mailing address
PO BOX 355, WENTWORTH, NC 27375
(336) 342-8316
(336) 342-8352
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111832
—
NC
Enumeration date
12/06/2006
Last updated
07/08/2007
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