Provider Demographics
NPI:1316156979
Name:MOOK, KAREN CORWIN (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CORWIN
Last Name:MOOK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TILLSON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-3451
Mailing Address - Country:US
Mailing Address - Phone:207-594-0105
Mailing Address - Fax:
Practice Address - Street 1:120 TILLSON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3451
Practice Address - Country:US
Practice Address - Phone:207-594-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist