Provider Demographics
NPI:1457555906
Name:COOK, TERESA KAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:KAY
Last Name:COOK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7229 GRAPETREE TRL
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7946
Mailing Address - Country:US
Mailing Address - Phone:901-261-4553
Mailing Address - Fax:901-261-4511
Practice Address - Street 1:3461 AUSTIN PEAY HWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3801
Practice Address - Country:US
Practice Address - Phone:901-261-4553
Practice Address - Fax:901-261-4511
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2844103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical