Provider Demographics
NPI:1164984464
Name:COOK, BETSY LEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:LEE
Last Name:COOK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3528
Mailing Address - Country:US
Mailing Address - Phone:940-867-7445
Mailing Address - Fax:
Practice Address - Street 1:1402 W ELM ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:TX
Practice Address - Zip Code:76374-1610
Practice Address - Country:US
Practice Address - Phone:940-564-5631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109590225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist