Individual
JILL COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHRT-CSP/MHRT-1
Contact information
Practice address
180 ACADEMY ST STE 2, PRESQUE ISLE, ME 04769-3183
(207) 764-3319
(207) 768-5377
Mailing address
180 ACADEMY ST STE 3, PRESQUE ISLE, ME 04769-3183
(075) 542-3522
(207) 554-2351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205383189
—
ME
Enumeration date
09/08/2016
Last updated
02/02/2021
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