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General NPI Number Information
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NPI Number | 1679690713
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Entity Type | Individual
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Provider Name | NOEL JUDITH AGOSTON LOPEZ-FREEMAN M.A.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 216 LAKELAND DR
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-6914
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Country | US
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Telephone | 213-999-3456
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270055
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City | FLOWER MOUND
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State | TX
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Zip | 75027-0055
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Country | US
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Telephone | 213-999-3456
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 204945
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 43215
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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