Provider Demographics
NPI:1851759831
Name:COOK, CARRIE E (MA CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:CARRIE
Middle Name:E
Last Name:COOK
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 WIND CHIME CT STE 104
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6486
Mailing Address - Country:US
Mailing Address - Phone:919-870-1280
Mailing Address - Fax:
Practice Address - Street 1:186 WIND CHIME CT STE 104
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6486
Practice Address - Country:US
Practice Address - Phone:919-870-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7793235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist