| Shannon Cook. Ph.d. | |
|
7220 Faulkner Ln #108 Trinity FL 34655-3667 | |
| (727) 255-3736 | |
| Not Available |
| Full Name | Shannon Cook. Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 7220 Faulkner Ln, Trinity, Florida |
| Authorized Official Name and Position | Shannon Cook (SOLE MENBER) |
| Authorized Official Contact | 7272553736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Cook. Ph.d. 7220 Faulkner Ln #108 Trinity FL 34655-3667 Ph: (727) 255-3736 | Shannon Cook. Ph.d. 7220 Faulkner Ln #108 Trinity FL 34655-3667 Ph: (727) 255-3736 |
| NPI Number | 1326289513 |
|---|---|
| Provider Enumeration Date | 03/17/2009 |
| Last Update Date | 07/16/2009 |
| Medicare PECOS PAC ID | 4082768452 |
|---|---|
| Medicare Enrollment ID | O20090819000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326289513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 7486 (Florida) | Primary |
| Provider Name | Shannon M Cook |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316098528 PECOS PAC ID: 4981702917 Enrollment ID: I20070614000213 |
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