Provider Demographics
NPI:1801349006
Name:CYKOSKY, TAMARA (BCBA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:CYKOSKY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18426-3089
Mailing Address - Country:US
Mailing Address - Phone:570-878-6716
Mailing Address - Fax:570-689-0515
Practice Address - Street 1:153 LAUREL LN
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18426-3089
Practice Address - Country:US
Practice Address - Phone:570-878-6716
Practice Address - Fax:570-689-0515
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000485103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst