Individual
MYRA COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 GENESIS DR, LAKE CITY, SC 29560-5531
(843) 389-3685
Mailing address
56 GENESIS DR, LAKE CITY, SC 29560-5531
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5202
SC
Other
Enumeration date
03/14/2015
Last updated
03/14/2015
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