Provider Demographics
NPI:1841772696
Name:COOK, AMANDA (OT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:825 S 169TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-9300
Mailing Address - Country:US
Mailing Address - Phone:402-354-4822
Mailing Address - Fax:402-354-4822
Practice Address - Street 1:717 N 190TH PLZ STE 3200
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3913
Practice Address - Country:US
Practice Address - Phone:402-815-8942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist