Provider Demographics
NPI:1669778460
Name:COOK SPEECH AND LANGUAGE, INC.
Entity type:Organization
Organization Name:COOK SPEECH AND LANGUAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-575-8800
Mailing Address - Street 1:1972 DEL PASO RD
Mailing Address - Street 2:SUITE 156
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-7724
Mailing Address - Country:US
Mailing Address - Phone:916-575-8800
Mailing Address - Fax:916-575-8822
Practice Address - Street 1:1972 DEL PASO RD
Practice Address - Street 2:SUITE 156
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-7724
Practice Address - Country:US
Practice Address - Phone:916-575-8800
Practice Address - Fax:916-575-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP12812235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty