Healthcare Provider Details

I. General information

NPI: 1184352569
Provider Name (Legal Business Name): MRS. JAYLA FREEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. JAYLA POUNDS

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GREEN MOUNTAIN DR APT 1404
LITTLE ROCK AR
72211-5121
US

IV. Provider business mailing address

701 GREEN MOUNTAIN DR APT 1404
LITTLE ROCK AR
72211-5121
US

V. Phone/Fax

Practice location:
  • Phone: 501-722-5140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number1261850666
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: