Provider Demographics
NPI:1144919416
Name:COOK SPEECH THERAPY AND REHAB
Entity type:Organization
Organization Name:COOK SPEECH THERAPY AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAUN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SKYRM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-256-0533
Mailing Address - Street 1:3 E POLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:PA
Mailing Address - Zip Code:16112-9109
Mailing Address - Country:US
Mailing Address - Phone:724-201-6170
Mailing Address - Fax:724-510-0737
Practice Address - Street 1:3 E POLAND AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:PA
Practice Address - Zip Code:16112-9109
Practice Address - Country:US
Practice Address - Phone:724-201-6170
Practice Address - Fax:724-510-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty