Provider Demographics
NPI:1215385844
Name:COOK, CHLOE (MS)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8253 CARLTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1212
Mailing Address - Country:US
Mailing Address - Phone:770-765-5637
Mailing Address - Fax:
Practice Address - Street 1:3636 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1646
Practice Address - Country:US
Practice Address - Phone:770-765-5637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist