Provider Demographics
NPI:1083837892
Name:COOK, TAMRA K (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:K
Last Name:COOK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:K
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:6321 E 102ND ST STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7046
Mailing Address - Country:US
Mailing Address - Phone:918-298-9486
Mailing Address - Fax:918-518-6212
Practice Address - Street 1:6321 E 102ND ST STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7046
Practice Address - Country:US
Practice Address - Phone:918-298-9486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist