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General NPI Number Information
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NPI Number | 1043753262
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Entity Type | Organization
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Legal Business Name | FREEDOM THERAPY CENTER, LLC
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Dates
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Enumeration Date | 11/19/2016
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 1102 TEXAS AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71301-4835
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Country | US
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Telephone | 318-613-0147
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 TEXAS AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71301-4835
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Country | US
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Telephone | 318-613-0147
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. DANIELLE D BAILEY
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Credential | LCSW
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Telephone | 318-613-0147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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