Provider Demographics
NPI:1083311641
Name:COOKSON, ANN PATRICIA (SLPA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:PATRICIA
Last Name:COOKSON
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PEJEPSCOT TER
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1689
Mailing Address - Country:US
Mailing Address - Phone:207-213-5500
Mailing Address - Fax:
Practice Address - Street 1:443 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6733
Practice Address - Country:US
Practice Address - Phone:207-577-4518
Practice Address - Fax:207-514-8260
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS38372355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant