Healthcare Provider Details

I. General information

NPI: 1023096310
Provider Name (Legal Business Name): LYNN E COOK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE NNMC, BLDG 7 ROOM 2138
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

3978 TRITON ST
FREDERICK MD
21704-7881
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-4959
  • Fax: 301-319-8325
Mailing address:
  • Phone: 301-874-0942
  • Fax: 301-319-8325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00519
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: