Healthcare Provider Details

I. General information

NPI: 1316351935
Provider Name (Legal Business Name): ALISON COOK PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BEDFORD ST STE 6
LEXINGTON MA
02420-4439
US

IV. Provider business mailing address

PO BOX 614
BIG HORN WY
82833-0614
US

V. Phone/Fax

Practice location:
  • Phone: 781-396-1199
  • Fax:
Mailing address:
  • Phone: 781-396-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: