Provider Demographics
NPI:1902541915
Name:COOK, MADDIE BRIER
Entity Type:Individual
Prefix:
First Name:MADDIE
Middle Name:BRIER
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 1:100 CONNELL DR APT 101
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-7730
Mailing Address - Country:US
Mailing Address - Phone:270-933-3990
Mailing Address - Fax:
Practice Address - Street 1:307 JASON DR STE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2774
Practice Address - Country:US
Practice Address - Phone:859-353-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist