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Organization

FREEBORN WELLNESS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA FREEBORN MSOT, OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(360) 584-3803
Entity
Organization

Contact information

Practice address
6920 43RD LOOP SE, LACEY, WA 98503-7114
(360) 584-3803
Mailing address
6920 43RD LOOP SE, LACEY, WA 98503-7114
(360) 584-3803

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60068984
WA
225XM0800X
Mental Health Occupational Therapist
225XP0200X
Pediatric Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2042848
WA
Enumeration date
01/20/2016
Last updated
06/03/2016
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