MEDICARE: RENEE FREUND

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	235Z00000X	Speech-Language Pathologist	SP-6448	OH

General Provider Information

NPI Number	:	1750793816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE FREUND

Provider Business Mailing Address
First Line	:	PO BOX 505
Second Line	:
City	:	BELLVILLE
State	:	OH
Zip	:	44813-0505
Country	:	US
Telephone Number	:	419-566-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 N LINDEN RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-2616
Country	:	US
Telephone Number	:	419-525-6307
Fax Number	:	419-525-6306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	05/23/2014

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Directions to “ RENEE FREUND ” Practice Location

Language	Start Address	Practice Location

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