Healthcare Provider Details

I. General information

NPI: 1528640315
Provider Name (Legal Business Name): ALAYNA JOSHALYNN FREEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 09/22/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48TH MDG RAF LAKENHEATH
APO AE
09461
US

IV. Provider business mailing address

PSC 41 BOX 2457
APO AE
09464-0025
US

V. Phone/Fax

Practice location:
  • Phone: 163-852-8638
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number78101
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number78101
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberU3843
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: