Provider Demographics
NPI:1861759938
Name:COOK, MOLLY (OT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:TOBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4808 S 109TH EAST AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5822
Mailing Address - Country:US
Mailing Address - Phone:918-392-1482
Mailing Address - Fax:918-392-7063
Practice Address - Street 1:4808 S 109TH EAST AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146
Practice Address - Country:US
Practice Address - Phone:918-392-1482
Practice Address - Fax:918-392-7063
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand