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General NPI Number Information
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NPI Number | 1023496577
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Entity Type | Organization
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Legal Business Name | ROBERT COOKE PC
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 300 W MAIN ST
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City | NORTHBOROUGH
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State | MA
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Zip | 01532-2132
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Country | US
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Telephone | 508-393-0316
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Fax | 603-843-2706
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Provider Business Mailing Address
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Address Line | 300 W MAIN ST
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City | NORTHBOROUGH
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State | MA
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Zip | 01532-2132
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Country | US
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Telephone | 508-393-0316
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Fax | 603-843-2706
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT K COOKE
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Credential | LICSW
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Telephone | 508-393-0316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1030761
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License Number State | MA
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