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NPI Code Detail

MEDICARE: MRS. MARY LIZ FREUND MSW

MEDICARE: MRS. MARY LIZ FREUND MSW
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
11041C0700XClinical Social Worker34001545AIN

General Provider Information

NPI Number : 1619975323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY LIZ FREUND MSW
Provider Business Mailing Address
First Line : 1633 N CAPITOL AVE
Second Line : STE 700
City : INDIANAPOLIS
State : IN
Zip : 46202-1261
Country : US
Telephone Number : 317-962-2700
Fax Number : 317-962-5039
Provider Business Practice Location Address
First Line : 1633 N CAPITOL AVE
Second Line : STE 700
City : INDIANAPOLIS
State : IN
Zip : 46202-1261
Country : US
Telephone Number : 317-962-2700
Fax Number : 317-962-5039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 05/20/2010

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