Provider Demographics
NPI:1295528669
Name:KULIG, MICHAELENE ANN
Entity type:Individual
Prefix:
First Name:MICHAELENE
Middle Name:ANN
Last Name:KULIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 DELLERT DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8881
Mailing Address - Country:US
Mailing Address - Phone:570-687-7896
Mailing Address - Fax:
Practice Address - Street 1:64 RIDGWAY DR STE 1
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-9263
Practice Address - Country:US
Practice Address - Phone:570-255-4578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist