Individual
JENNIFER COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD, LMSW
Contact information
Practice address
2080 N STATE HIGHWAY 360 STE 350, GRAND PRAIRIE, TX 75050-1451
(817) 812-4723
(817) 812-6042
Mailing address
2080 N STATE HIGHWAY 360 STE 350, GRAND PRAIRIE, TX 75050-1451
(817) 812-4723
(817) 812-6042
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84249
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT84249
LD LICENSE
TX
Enumeration date
05/01/2020
Last updated
05/01/2020
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