Provider Demographics
NPI:1407997505
Name:FREEDMAN, LINDA (LOTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9534 DELCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4122
Mailing Address - Country:US
Mailing Address - Phone:225-926-8880
Mailing Address - Fax:225-928-4122
Practice Address - Street 1:9534 DELCOURT AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4122
Practice Address - Country:US
Practice Address - Phone:225-926-8880
Practice Address - Fax:225-928-4122
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12022225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721342481OtherUNITED HEALTHCARE
LA721342481OtherTAX ID
LA194516Medicare ID - Type Unspecified