Individual
DR. MARK ANTHONY COOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
172 CLARKSON EXECUTIVE PARK, ELLISVILLE, MO 63011-2114
(636) 230-3113
(636) 230-3044
Mailing address
172 CLARKSON EXECUTIVE PARK, ELLISVILLE, MO 63011-2114
(636) 230-3113
(636) 230-3044
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01227
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115397
HEALTHLINK PPO
—
01
—
431466627C00
MERCY UNITY HEALTH PLAN
—
01
—
5018
BLUE CROSS BLUE SHIELD MO
—
Enumeration date
12/29/2005
Last updated
07/08/2007
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