Provider Demographics
NPI:1760782114
Name:ZIELINSKI, ANGELA S (OTD, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:S
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4981 STONE MOSS WAY
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-1797
Mailing Address - Country:US
Mailing Address - Phone:706-870-3897
Mailing Address - Fax:
Practice Address - Street 1:3100 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:SUITE 203
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-1890
Practice Address - Country:US
Practice Address - Phone:706-870-3897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003291225X00000X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics