Provider Demographics
NPI:1194127621
Name:COOK, DELANO (BA AA)
Entity type:Individual
Prefix:
First Name:DELANO
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:BA AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 COUNTY ROAD 9 SOUTH
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101
Mailing Address - Country:US
Mailing Address - Phone:719-587-4592
Mailing Address - Fax:
Practice Address - Street 1:8745 COUNTY ROAD 9 SOUTH
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101
Practice Address - Country:US
Practice Address - Phone:719-587-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator