Healthcare Provider Details

I. General information

NPI: 1770531642
Provider Name (Legal Business Name): SALLIE B. FREEMAN PHD, BSN, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 N DECATUR RD
DECATUR GA
30033-5307
US

IV. Provider business mailing address

904 CLIFTON RD NE
ATLANTA GA
30307-1226
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-8484
  • Fax:
Mailing address:
  • Phone: 404-778-8484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN072858
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: