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General NPI Number Information
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NPI Number | 1992174254
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Entity Type | Individual
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Provider Name | CANDICE FREEMAN OTD, MOT, OTR
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Gender | Female
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 8355 WALNUT HILL LN STE 225A
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City | DALLAS
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State | TX
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Zip | 75231-4241
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Country | US
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Telephone | 972-685-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 CALLAHAN DR
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City | FORNEY
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State | TX
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Zip | 75126-5107
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Country | US
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Telephone | 214-870-1473
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 112074
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 112074
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License Number State | TX
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