Provider Demographics
NPI:1144590050
Name:COOK, TERRI LYNNE (LPT)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNNE
Last Name:COOK
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5243
Mailing Address - Country:US
Mailing Address - Phone:805-459-7283
Mailing Address - Fax:805-781-4866
Practice Address - Street 1:784 HIGH ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5243
Practice Address - Country:US
Practice Address - Phone:805-459-7283
Practice Address - Fax:805-781-4866
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health