Provider Demographics
NPI:1831585371
Name:COOK, CASAANDRA
Entity type:Individual
Prefix:
First Name:CASAANDRA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 S GOLDWYN AVE
Mailing Address - Street 2:SUTIE 219
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-4324
Mailing Address - Country:US
Mailing Address - Phone:407-985-4236
Mailing Address - Fax:407-250-3445
Practice Address - Street 1:927 S GOLDWYN AVE
Practice Address - Street 2:SUTIE 219
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-4324
Practice Address - Country:US
Practice Address - Phone:407-985-4236
Practice Address - Fax:407-250-3445
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health