Provider Demographics
NPI:1013287093
Name:COOK, JULIET RENAE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:RENAE
Last Name:COOK
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 OAK GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-8601
Mailing Address - Country:US
Mailing Address - Phone:870-269-7059
Mailing Address - Fax:870-269-7060
Practice Address - Street 1:706 OAK GROVE ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-8601
Practice Address - Country:US
Practice Address - Phone:870-269-7059
Practice Address - Fax:870-269-7060
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist