NPI Code Details Logo

NPI 1821952052

NPI 1821952052 : SUZANNE FREEDBERG PH.D. : CAMBRIDGE, MA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1821952052
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SUZANNE FREEDBERG PH.D.
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/11/2025
-----------------------------------------------------
    Last Update Date     |    12/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11 MARIE AVE # 3 
-----------------------------------------------------
    City                 |    CAMBRIDGE
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    02139-1002
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    617-943-0227
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    11 MARIE AVE # 3 
-----------------------------------------------------
    City                 |    CAMBRIDGE
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    02139-1002
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103TS0200X
-----------------------------------------------------
    Taxonomy Name        |    School Psychologist
-----------------------------------------------------
    License Number       |    33897
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    103TC2200X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Child & Adolescent Psychologist
-----------------------------------------------------
    License Number       |    33897
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.