Provider Demographics
NPI:1013990951
Name:COOK, MARGARETTE JEANETTE (MSED MS CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:MARGARETTE
Middle Name:JEANETTE
Last Name:COOK
Suffix:
Gender:F
Credentials:MSED MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 CAMILO LN NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2823
Mailing Address - Country:US
Mailing Address - Phone:505-328-4073
Mailing Address - Fax:
Practice Address - Street 1:5199 MARNA LYNN
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114
Practice Address - Country:US
Practice Address - Phone:505-898-0923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000OTHMedicare UPIN