Healthcare Provider Details

I. General information

NPI: 1639001597
Provider Name (Legal Business Name): MAYA FREELON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 GUESS RD STE B
DURHAM NC
27705-2678
US

IV. Provider business mailing address

5547 INVERNESS DR
DURHAM NC
27712-1841
US

V. Phone/Fax

Practice location:
  • Phone: 919-477-9887
  • Fax:
Mailing address:
  • Phone: 919-491-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number23343
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: