Individual
BLAKE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 CRESCENT AVE, PASSAIC, NJ 07055-2437
(201) 421-7371
Mailing address
16 SCHMITT RD, WEST ORANGE, NJ 07052-2227
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05454100
NJ
Other
Enumeration date
07/06/2020
Last updated
07/08/2020
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