Provider Demographics
NPI:1568630820
Name:COOK, JUDITH (OT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220-3103
Mailing Address - Country:US
Mailing Address - Phone:603-524-3397
Mailing Address - Fax:
Practice Address - Street 1:8 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-3103
Practice Address - Country:US
Practice Address - Phone:603-524-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0417225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist