Provider Demographics
NPI:1962796938
Name:COOK, MABLE B (MS SLP)
Entity type:Individual
Prefix:MS
First Name:MABLE
Middle Name:B
Last Name:COOK
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21131 STONEY HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6582
Mailing Address - Country:US
Mailing Address - Phone:225-288-1995
Mailing Address - Fax:
Practice Address - Street 1:21131 STONEY HAVEN DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6582
Practice Address - Country:US
Practice Address - Phone:225-288-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6251235Z00000X
TX106821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist