Healthcare Provider Details

I. General information

NPI: 1164352944
Provider Name (Legal Business Name): GEOVANNA FREIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 CEDAR ST
WORCESTER MA
01609-2134
US

IV. Provider business mailing address

47 N MAIN ST
UXBRIDGE MA
01569-1719
US

V. Phone/Fax

Practice location:
  • Phone: 978-254-1002
  • Fax:
Mailing address:
  • Phone: 774-214-8079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: