Provider Demographics
NPI:1811478670
Name:COOK, LOUISA COLLEEN (MS-CCC/SLP)
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:COLLEEN
Last Name:COOK
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:MRS
Other - First Name:LOUISA
Other - Middle Name:COLLEEN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOUISA JARDIN
Mailing Address - Street 1:6617 RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2365
Mailing Address - Country:US
Mailing Address - Phone:419-944-6416
Mailing Address - Fax:
Practice Address - Street 1:6101 OHIO DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2720
Practice Address - Country:US
Practice Address - Phone:419-944-6416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist