Individual
MARY KATHERINE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-CC
Contact information
Practice address
190 LANCASTER ST STE 310, PORTLAND, ME 04101-2058
(207) 560-7152
Mailing address
190 LANCASTER ST STE 310, PORTLAND, ME 04101-2058
(207) 560-7152
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC17313
ME
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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