Provider Demographics
NPI:1629327309
Name:ZALIG, ANGELA M
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:ZALIG
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 1:200 N JEFFERSON ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-5166
Mailing Address - Country:US
Mailing Address - Phone:920-448-5234
Mailing Address - Fax:920-448-5265
Practice Address - Street 1:200 N JEFFERSON ST
Practice Address - Street 2:SUITE 511
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-5166
Practice Address - Country:US
Practice Address - Phone:920-448-5234
Practice Address - Fax:920-448-5265
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2255R0406X2255R0406X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind