Provider Demographics
NPI:1245673516
Name:COOK-THERIAULT, HARMONY JOY (LMT)
Entity type:Individual
Prefix:MRS
First Name:HARMONY
Middle Name:JOY
Last Name:COOK-THERIAULT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:HARMONY
Other - Middle Name:JOY
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3132 CAUTHEN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-2933
Mailing Address - Country:US
Mailing Address - Phone:321-987-6389
Mailing Address - Fax:
Practice Address - Street 1:3132 CAUTHEN CREEK DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-2933
Practice Address - Country:US
Practice Address - Phone:321-987-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800175T00000X
372500000X, 372600000X, 376J00000X
FL105821225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175T00000XOther Service ProvidersPeer Specialist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker