Provider Demographics
NPI:1659794006
Name:ZANGARA, VIKKI LAUREL (OTA/L)
Entity Type:Individual
Prefix:MRS
First Name:VIKKI
Middle Name:LAUREL
Last Name:ZANGARA
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 W 212TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2708
Mailing Address - Country:US
Mailing Address - Phone:440-463-5645
Mailing Address - Fax:
Practice Address - Street 1:2791 MOGADORE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1504
Practice Address - Country:US
Practice Address - Phone:330-670-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 01803224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant