Provider Demographics
NPI:1063286383
Name:COOK, CATHERINE ANNE (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANNE
Last Name:COOK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 WALNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5054
Mailing Address - Country:US
Mailing Address - Phone:903-309-3816
Mailing Address - Fax:888-245-6178
Practice Address - Street 1:911 WALNUT HILL DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5054
Practice Address - Country:US
Practice Address - Phone:903-309-3816
Practice Address - Fax:888-245-6178
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty