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NPI Code Detail

MEDICARE: MS. DIANA MARIE FREELAND LCSW

MEDICARE: MS. DIANA MARIE FREELAND LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1336700731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA MARIE FREELAND LCSW
Provider Business Mailing Address
First Line : 6550 FANNIN ST STE 2509
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2777
Country : US
Telephone Number : 346-238-2040
Fax Number :
Provider Business Practice Location Address
First Line : 6550 FANNIN ST STE 2509
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2777
Country : US
Telephone Number : 346-238-2040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2019
Last Update Date : 06/26/2019

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