Provider Demographics
NPI:1861628216
Name:COOK-MCKINNEY, CHRISTA L (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:L
Last Name:COOK-MCKINNEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:CHRISTA
Other - Middle Name:L
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:MAINE EDUCATIONAL CENTER FOR THE DEAF AND HARD OF HEARI
Mailing Address - Street 2:1 MACKWORTH ISLAND
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1900
Mailing Address - Country:US
Mailing Address - Phone:207-781-3165
Mailing Address - Fax:207-781-6296
Practice Address - Street 1:MAINE EDUCATIONAL CENTER FOR THE DEAF AND HARD OF HEARI
Practice Address - Street 2:1 MACKWORTH ISLAND
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1900
Practice Address - Country:US
Practice Address - Phone:207-781-3165
Practice Address - Fax:207-781-6296
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1186235Z00000X
MESP2062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist