Provider Demographics
NPI:1912214156
Name:FREEDMAN, PEGGY A (OTR/L)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:A
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SPECTRUM CIR.
Mailing Address - Street 2:SUITE B316
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:770-541-7401
Mailing Address - Fax:770-541-7403
Practice Address - Street 1:1950 SPECTRUM CIR.
Practice Address - Street 2:SUITE B316
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:770-541-7401
Practice Address - Fax:770-541-7403
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000071225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist