Provider Demographics
NPI:1487037495
Name:COOK, MARIAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2215
Mailing Address - Street 2:257 EAST MAIN STREET
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762
Mailing Address - Country:US
Mailing Address - Phone:828-668-1711
Mailing Address - Fax:
Practice Address - Street 1:611 OLD US HWY 70E
Practice Address - Street 2:MOUNTAIN RIDGE SKILLED NURSING
Practice Address - City:BLACK MTN
Practice Address - State:NC
Practice Address - Zip Code:28711
Practice Address - Country:US
Practice Address - Phone:828-669-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1765225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist