Provider Demographics
NPI:1285116145
Name:FREEMAN, LAURA KAY
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1503
Mailing Address - Country:US
Mailing Address - Phone:770-598-3809
Mailing Address - Fax:
Practice Address - Street 1:103 NORTH RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:CT
Practice Address - Zip Code:06280-1311
Practice Address - Country:US
Practice Address - Phone:860-423-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist