Individual
MRS. MELISSA KUKOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
245 OLD LAKE RD, DALLAS, PA 18612-3154
(570) 639-1885
Mailing address
447 PATLA RD, SWEET VALLEY, PA 18656-2217
(570) 239-0454
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP008373
PA
Other
Enumeration date
01/14/2018
Last updated
01/14/2018
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