Provider Demographics
NPI:1316824881
Name:COOK, REAGAN MICHELLE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:REAGAN
Middle Name:MICHELLE
Last Name:COOK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2687 KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5837
Mailing Address - Country:US
Mailing Address - Phone:662-871-1704
Mailing Address - Fax:
Practice Address - Street 1:4125 HUNTERS PARK LN STE 116
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7615
Practice Address - Country:US
Practice Address - Phone:407-855-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26404225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist