Individual
ALICIA L COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
902 RIVERSIDE DR STE 204, WAUPACA, WI 54981-1992
(920) 720-2300
(920) 720-3719
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 454-4101
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15837
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760704910
—
WI
Enumeration date
02/15/2010
Last updated
04/21/2020
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