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General NPI Number Information
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NPI Number | 1467871772
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Entity Type | Organization
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Legal Business Name | LEGAL MINDS, INC - A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 4520 CALIFORNIA AVE STE 210
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1190
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Country | US
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Telephone | 800-792-9129
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Fax | 855-278-9129
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Provider Business Mailing Address
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Address Line | 4520 CALIFORNIA AVE STE 210
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1190
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Country | US
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Telephone | 800-792-9129
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Fax | 855-278-9129
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMYANNE FREEBURG
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Credential | PSY.D., MSCP
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Telephone | 800-792-9129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY22152
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22152
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License Number State | CA
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