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Individual

RUTH E COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC/A

Contact information

Practice address
1250 FOREST AVE, SUITE 301, PORTLAND, ME 04103-1884
(207) 797-5753
(207) 878-1715
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AP1052
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027843
ANTHEM
ME
05
317990099
ME
Enumeration date
10/18/2005
Last updated
04/03/2012
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