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General NPI Number Information
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NPI Number | 1467218511
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Entity Type | Organization
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Legal Business Name | SHELBY FREEMAN LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 215 N EAST AVE STE 205
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5226
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Country | US
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Telephone | 479-409-5310
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Fax |
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Provider Business Mailing Address
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Address Line | 215 N EAST AVE STE 205
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5226
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | SHELBY FREEMAN
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Credential | LPC CRC
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Telephone | 479-409-5310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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