MEDICARE: FREEDOM INTERACTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0470	NV
2	225XP0200X	Pediatric Occupational Therapist	0470	NV

General Provider Information

NPI Number	:	1598842866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM INTERACTION

Provider Business Mailing Address
First Line	:	7065 W ANN RD
Second Line	:	#130-300
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3865
Country	:	US
Telephone Number	:	702-396-0101
Fax Number	:	702-222-0212

Provider Business Practice Location Address
First Line	:	2251 S JONES BLVD
Second Line	:	SUITE 121
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3164
Country	:	US
Telephone Number	:	702-396-0101
Fax Number	:	702-222-0212

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MONA HIBBERT AGAMEZ
Credential	:	OTR/L
Telephone Number	:	702-393-0101

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	09/11/2025

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Directions to “FREEDOM INTERACTION ” Practice Location

Language	Start Address	Practice Location

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