Individual
ALICIA COOLBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
401 PENN AVE, SCRANTON, PA 18503-1213
(570) 961-4300
Mailing address
506 OLD MILL RD, DALLAS, PA 18612-7721
(570) 540-6533
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012384
PA
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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