Organization
COOK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE INGENITO (CREDENTIALING SPECIALISTS)
(570) 352-3063
Entity
Organization
Contact information
Practice address
533 N NOVA RD, ORMOND BEACH, FL 32174-4447
(386) 566-1310
Mailing address
2665 N ATLANTIC AVE # 361, DAYTONA BEACH, FL 32118-3205
(386) 566-1310
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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