Provider Demographics
NPI:1568188563
Name:CYBULSKI, MICHELLE ARLIENE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ARLIENE
Last Name:CYBULSKI
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 COMMUNITY WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2301
Mailing Address - Country:US
Mailing Address - Phone:717-393-0425
Mailing Address - Fax:717-455-3838
Practice Address - Street 1:625 COMMUNITY WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2301
Practice Address - Country:US
Practice Address - Phone:717-393-0425
Practice Address - Fax:717-455-3838
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist