Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 5469 | OH |
NPI | 1013046135 |
---|---|
Provider Name | Dr. Colleen M Cook |
First Address | Portsmouth, NH 03801-4351 |
Second Address | Portsmouth, NH 03801-5437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 09/11/2016 |