Individual
TARA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
256 HONEYSUCKLE RD STE 6, DOTHAN, AL 36305-1168
(334) 792-5020
(334) 460-8468
Mailing address
105 CULLODEN CT, DOTHAN, AL 36305-7205
(334) 258-0888
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43478
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-43478
BACB
—
Enumeration date
02/14/2018
Last updated
07/24/2020
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