Individual
MRS. KATHERINE M MARKS COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LADC
Contact information
Practice address
30 BOYNTON ST, BOX H EASTPORT HEALTH CARE INC, EASTPORT, ME 04631
(207) 853-6001
(207) 853-4028
Mailing address
30 BOYNTON ST, BOX H EASTPORT HEALTH CARE INC, EASTPORT, ME 04631
(207) 853-6001
(207) 853-4028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC2728
ME
1041C0700X
Clinical Social Worker
Primary
LC8576
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320310099
—
ME
Enumeration date
10/17/2006
Last updated
06/02/2010
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