Provider Demographics
NPI:1295543965
Name:COOK, ZAYAH M
Entity type:Individual
Prefix:
First Name:ZAYAH
Middle Name:M
Last Name:COOK
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 S 50 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5559
Mailing Address - Country:US
Mailing Address - Phone:801-548-3091
Mailing Address - Fax:801-992-7150
Practice Address - Street 1:5307 S KNOLLCREST ST APT A
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6320
Practice Address - Country:US
Practice Address - Phone:208-901-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician