Individual
NATHAN COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 748-1227
Mailing address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293000
—
VA
Enumeration date
06/29/2017
Last updated
06/29/2017
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