Individual
DESTINY DAWN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
186 MAIN ST, SUITE 4, FARMINGTON, ME 04938-1921
(207) 620-4103
Mailing address
186 MAIN ST, SUITE 4, FARMINGTON, ME 04938-1921
(207) 620-4103
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT3911
ME
Other
Enumeration date
01/12/2009
Last updated
07/22/2016
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