MEDICARE: MRS. ANGELA S ZIELINSKI OTD, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	003291	GA
2	225XP0019X	Physical Rehabilitation Occupational Therapist	003291	GA
3	225XP0200X	Pediatric Occupational Therapist	003291	GA

General Provider Information

NPI Number	:	1760782114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA S ZIELINSKI OTD, OTR/L

Provider Business Mailing Address
First Line	:	4981 STONE MOSS WAY
Second Line	:
City	:	HOSCHTON
State	:	GA
Zip	:	30548-1797
Country	:	US
Telephone Number	:	706-870-3897
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 FIVE FORKS TRICKUM RD SW
Second Line	:	SUITE 203
City	:	LILBURN
State	:	GA
Zip	:	30047-1890
Country	:	US
Telephone Number	:	706-870-3897
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	04/12/2016

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