Healthcare Provider Details

I. General information

NPI: 1497681332
Provider Name (Legal Business Name): MS. SHIRLEY MCDUFFIE FREEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 DILLARD DR
CARY NC
27518-9226
US

IV. Provider business mailing address

121 HUNT CLUB LN APT D
RALEIGH NC
27606-1590
US

V. Phone/Fax

Practice location:
  • Phone: 919-533-7200
  • Fax:
Mailing address:
  • Phone: 919-219-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number0445
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: