Provider Demographics
NPI:1902216815
Name:COOK, CAMILLE C
Entity Type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:C
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 1:7465 W. LAKE MEAD BLVD STE. 100
Mailing Address - Street 2:C/O 8 DIMENSIONS OF WELLNESS MASSEY & ASSOCIATES
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:702-782-9958
Mailing Address - Fax:
Practice Address - Street 1:7465 W. LAKE MEAD BLVD STE. 100
Practice Address - Street 2:C/O 8 DIMENSIONS OF WELLNESS MASSEY & ASSOCIATES
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-782-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator