Provider Demographics
NPI:1225402308
Name:COOKS, VICTORIA (BA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:COOKS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:HARTFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:6907 OLD HIGHWAY 165 SOUTH
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418
Mailing Address - Country:US
Mailing Address - Phone:318-649-6399
Mailing Address - Fax:318-649-2356
Practice Address - Street 1:6907 OLD HIGHWAY 165 SOUTH
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418
Practice Address - Country:US
Practice Address - Phone:318-649-6399
Practice Address - Fax:318-649-2356
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health