Individual
MARY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
7200 DENTON HWY, WATAUGA, TX 76148-1202
(817) 691-3283
Mailing address
3100 PREMIER DR STE 234, IRVING, TX 75063-2693
(916) 765-2208
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-29300
BACB
TX
Enumeration date
03/26/2018
Last updated
09/27/2018
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