Provider Demographics
NPI:1285322925
Name:OSTROSKI, MICHELLE LYNN (EDD, LSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:OSTROSKI
Suffix:
Gender:F
Credentials:EDD, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 HUNTER HWY
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-7981
Mailing Address - Country:US
Mailing Address - Phone:570-574-4792
Mailing Address - Fax:
Practice Address - Street 1:505 HUNTER HWY STE 2
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-8064
Practice Address - Country:US
Practice Address - Phone:570-575-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135810104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker