Provider Demographics
NPI:1073569646
Name:COOK, DOSHEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOSHEEN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 VASSAR STREET
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-737-9890
Mailing Address - Fax:775-990-1221
Practice Address - Street 1:2450 VASSAR STREET
Practice Address - Street 2:SUITE 3A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-737-9890
Practice Address - Fax:775-990-1221
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0482103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV004716904Medicaid
NVQ52799Medicare UPIN
NV004716904Medicaid