Provider Demographics
NPI:1982475349
Name:COOK, JONATHAN SETH
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:SETH
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DARNELL ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-1100
Mailing Address - Country:US
Mailing Address - Phone:270-399-1783
Mailing Address - Fax:
Practice Address - Street 1:102 DARNELL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-1100
Practice Address - Country:US
Practice Address - Phone:270-399-1783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist