Provider Demographics
NPI:1306219985
Name:FREEDMAN, MARCY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CHURCHILL CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3203
Mailing Address - Country:US
Mailing Address - Phone:248-320-9328
Mailing Address - Fax:
Practice Address - Street 1:12 CHURCHILL CT
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-3203
Practice Address - Country:US
Practice Address - Phone:248-320-9328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00665200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist