Provider Demographics
NPI:1164601647
Name:COOK, FRANCES MARLENE (SLP, MS)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:MARLENE
Last Name:COOK
Suffix:
Gender:F
Credentials:SLP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HARLEY O STAGGERS SR DR
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2819
Mailing Address - Country:US
Mailing Address - Phone:304-267-3595
Mailing Address - Fax:
Practice Address - Street 1:ONE BAKER PLACE
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726
Practice Address - Country:US
Practice Address - Phone:304-788-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0155246000Medicaid