Provider Demographics
NPI:1093434110
Name:COOK, KATHRYN LEEANN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEEANN
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 BEREA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-5126
Mailing Address - Country:US
Mailing Address - Phone:540-845-2149
Mailing Address - Fax:
Practice Address - Street 1:8723 LAROQUE RUN DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-1991
Practice Address - Country:US
Practice Address - Phone:540-693-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant