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General NPI Number Information
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NPI Number | 1740037753
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Entity Type | Individual
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Provider Name | ANDREA FREEMAN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 3190 NORTHEAST EXPY NE STE 110
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City | ATLANTA
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State | GA
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Zip | 30341-5323
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Country | US
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Telephone | 404-487-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 3367 PEACHTREE CORNERS CIR APT P
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-3686
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Country | US
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Telephone | 404-310-0022
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 20-112607
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License Number State | GA
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