Provider Demographics
NPI:1013035856
Name:SOKOLIK, MELISSA ELLEN (OTRL)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ELLEN
Last Name:SOKOLIK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4205
Mailing Address - Country:US
Mailing Address - Phone:860-496-1430
Mailing Address - Fax:
Practice Address - Street 1:287 WEST ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3501
Practice Address - Country:US
Practice Address - Phone:860-529-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002837225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0720006Medicare ID - Type Unspecified