Individual
MARTY T. COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
500 S 11TH AVE, SUITE 302, POCATELLO, ID 83201-4835
(208) 233-0150
(208) 233-0159
Mailing address
PO BOX 4986, POCATELLO, ID 83205-4986
(208) 233-0150
(208) 233-0159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC3448
ID
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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