Provider Demographics
NPI:1083867642
Name:MARGUERITE M. MIKULSKI
Entity Type:Organization
Organization Name:MARGUERITE M. MIKULSKI
Other - Org Name:INTEGRATED THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MIKULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:585-343-1840
Mailing Address - Street 1:25 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3246
Mailing Address - Country:US
Mailing Address - Phone:585-343-1840
Mailing Address - Fax:585-343-2185
Practice Address - Street 1:25 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3246
Practice Address - Country:US
Practice Address - Phone:585-343-1840
Practice Address - Fax:585-343-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency