Healthcare Provider Details

I. General information

NPI: 1841100823
Provider Name (Legal Business Name): MACKENZIE FREEMAN ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7667 W CONGRESS ST
MILWAUKEE WI
53218-5349
US

IV. Provider business mailing address

4956 N 66TH ST
MILWAUKEE WI
53218-4034
US

V. Phone/Fax

Practice location:
  • Phone: 414-393-4269
  • Fax:
Mailing address:
  • Phone: 414-588-8197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: