Provider Demographics
NPI:1336483148
Name:COOK, CHRISTINA D
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:D
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 ELK CANYON COURT
Mailing Address - Street 2:
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73162
Mailing Address - Country:US
Mailing Address - Phone:405-473-3569
Mailing Address - Fax:
Practice Address - Street 1:6701 W WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-5492
Practice Address - Country:US
Practice Address - Phone:405-470-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health