Provider Demographics
NPI:1487925178
Name:FREEDMAN, RENEE (OTR/L)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9221 E BASELINE RD STE A109-617
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8379
Mailing Address - Country:US
Mailing Address - Phone:480-251-9171
Mailing Address - Fax:480-357-4639
Practice Address - Street 1:3984 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1461
Practice Address - Country:US
Practice Address - Phone:203-858-8875
Practice Address - Fax:480-357-4639
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00564500224Z00000X
NY001233225X00000X
AZ7078225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant