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General NPI Number Information
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NPI Number | 1750860094
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Entity Type | Organization
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Legal Business Name | REENA C FREEMAN PSYD LLC
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 102 RENAISSANCE CIR
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City | MAULDIN
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State | SC
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Zip | 29662
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Country | US
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Telephone | 864-214-4303
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Fax |
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Provider Business Mailing Address
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Address Line | 102 RENAISSANCE CIR
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City | MAULDIN
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State | SC
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Zip | 29662-2455
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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 | LICENSED PSYCHOLOGIST
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Name | DR. REENA C FREEMAN
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Credential |
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Telephone | 864-214-4303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1503
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License Number State | SC
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