Provider Demographics
NPI:1558184390
Name:ZYLA, ANDREA NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:ZYLA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:NICOLE
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10909 MILL VALLEY RD STE 210
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3950
Mailing Address - Country:US
Mailing Address - Phone:402-391-5002
Mailing Address - Fax:402-343-1278
Practice Address - Street 1:1001 FORT CROOK RD N STE 202
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4226
Practice Address - Country:US
Practice Address - Phone:402-763-4408
Practice Address - Fax:402-343-1278
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2968225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist