Provider Demographics
NPI:1245928555
Name:COOK, KAYLEE ELIZABETH
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ELIZABETH
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 1:592 ISABELLE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3707
Mailing Address - Country:US
Mailing Address - Phone:682-559-3164
Mailing Address - Fax:
Practice Address - Street 1:1101 JOHN A DENIE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7630
Practice Address - Country:US
Practice Address - Phone:901-372-2269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health