Provider Demographics
NPI:1841413515
Name:COOK, NICOLE MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:LABONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:16 CRESCENT ST
Mailing Address - City:HUNTINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01050-0445
Mailing Address - Country:US
Mailing Address - Phone:413-667-5604
Mailing Address - Fax:
Practice Address - Street 1:40 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2018
Practice Address - Country:US
Practice Address - Phone:413-637-5011
Practice Address - Fax:413-637-4752
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7740225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist