Provider Demographics
NPI:1720631526
Name:FREITAS, LAURA MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:FREITAS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-2719
Mailing Address - Country:US
Mailing Address - Phone:508-789-6111
Mailing Address - Fax:949-864-3131
Practice Address - Street 1:209 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2719
Practice Address - Country:US
Practice Address - Phone:508-789-6111
Practice Address - Fax:949-864-3131
Is Sole Proprietor?:No
Enumeration Date:2019-07-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2286573363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health