Provider Demographics
NPI:1295980662
Name:COOKE, ANNETTE PATRICIA (EDM)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:PATRICIA
Last Name:COOKE
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 PRESIDENT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1101
Mailing Address - Country:US
Mailing Address - Phone:347-587-3161
Mailing Address - Fax:
Practice Address - Street 1:637 PRESIDENT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1101
Practice Address - Country:US
Practice Address - Phone:347-587-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst