Individual
JARED FRANKLIN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-9810
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-9810
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107718
—
NC
Enumeration date
09/06/2011
Last updated
01/04/2012
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