Provider Demographics
NPI:1922732387
Name:FREER, SYDNEY LAUREN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:LAUREN
Last Name:FREER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 DALLAS ROAD 141
Mailing Address - Street 2:
Mailing Address - City:BEARDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71720-8817
Mailing Address - Country:US
Mailing Address - Phone:870-814-6999
Mailing Address - Fax:
Practice Address - Street 1:147 DALLAS ROAD 141
Practice Address - Street 2:
Practice Address - City:BEARDEN
Practice Address - State:AR
Practice Address - Zip Code:71720-8817
Practice Address - Country:US
Practice Address - Phone:870-814-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1010224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant