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General NPI Number Information
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NPI Number | 1477000206
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Entity Type | Individual
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Provider Name | ASIHA ALLEN-FREEMAN
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Gender | Female
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 3654 KATELYN LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46228-7020
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Country | US
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Telephone | 317-601-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 W BETHEL AVE APT 1131
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City | MUNCIE
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State | IN
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Zip | 47304-5691
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Country | US
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Telephone | 317-601-1424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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