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General NPI Number Information
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NPI Number | 1386110633
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Entity Type | Organization
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Legal Business Name | FREEDOM BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | SCHWALBENWEG 5
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City | LUPBURG
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State | BAYERN
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Zip | 92331
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Country | DE
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Telephone | 724-278-3417
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Fax |
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Provider Business Mailing Address
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Address Line | SCHWALBENWEG 5
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City | LUPBURG
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State | BAYERN
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Zip | 92331
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Country | DE
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, BCBA
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Name | AMBER CLAYTON
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Credential | LBA, BCBA
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Telephone | 724-278-3417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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