Provider Demographics
NPI:1902211618
Name:MEREDITH COOK, TAMMY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MEREDITH COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:MEREDITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 LOWELL RD
Mailing Address - Street 2:102
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1370
Mailing Address - Country:US
Mailing Address - Phone:903-975-5219
Mailing Address - Fax:
Practice Address - Street 1:19 LOWELL RD
Practice Address - Street 2:102
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1370
Practice Address - Country:US
Practice Address - Phone:903-975-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker