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Individual

JASON EVAN COOK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
1020 FRANKLIN ST, 6TH FLOOR, JOHNSTOWN, PA 15905-4109
(814) 534-1085
(814) 534-1431
Mailing address
1086 FRANKLIN ST, 6TH FLOOR, JOHNSTOWN, PA 15905-4305
(814) 534-1095
(814) 534-1431

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS008739L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01694292
PA
Enumeration date
01/09/2006
Last updated
07/08/2007
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