Organization
FREEBORN WELLNESS, PLLC
Active
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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