Provider Demographics
NPI:1861184574
Name:COOK, BREAN ARIANA
Entity type:Individual
Prefix:MISS
First Name:BREAN
Middle Name:ARIANA
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 1:1055 S ELMORA AVE APT 2U
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-2462
Mailing Address - Country:US
Mailing Address - Phone:201-948-6398
Mailing Address - Fax:
Practice Address - Street 1:1055 S ELMORA AVE APT 2U
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2462
Practice Address - Country:US
Practice Address - Phone:201-948-6398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst