Individual
FELISSA LULKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
25 CARRIER ST, LIBERTY, NY 12754-1903
(845) 281-7200
Mailing address
45 RUTH CT, MIDDLETOWN, NY 10940-5329
(845) 649-8092
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
P118595
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P118595
TEMP OTA LICENSE
NY
Enumeration date
10/25/2022
Last updated
10/25/2022
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