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NPI Code Detail

MEDICARE: NICOLE FREEBERG

MEDICARE: NICOLE FREEBERG
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
1235Z00000XSpeech-Language PathologistSA19220FL
2235Z00000XSpeech-Language PathologistLL61195420WA

General Provider Information

NPI Number : 1336810704
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE FREEBERG
Provider Business Mailing Address
First Line : 3651 22ND ST S
Second Line :
City : FARGO
State : ND
Zip : 58104-6595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2320 BORST AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-1410
Country : US
Telephone Number : 360-330-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2021
Last Update Date : 09/24/2021

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Directions to “ NICOLE FREEBERG ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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