Individual
REGINA COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2603
Mailing address
1315 WINDRIM AVE, PHILADELPHIA, PA 19141-2710
(215) 456-2603
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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