Provider Demographics
NPI:1073250684
Name:COOK, ELIZABETH MAE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAE
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 COWELL ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-1221
Mailing Address - Country:US
Mailing Address - Phone:508-642-8858
Mailing Address - Fax:
Practice Address - Street 1:33 COWELL ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-1221
Practice Address - Country:US
Practice Address - Phone:508-642-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health