Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-13-14074 | FL |
NPI | 1013358860 |
---|---|
Provider Name | Dr. Carlos Freeman |
First Address | Lincoln, NE 68526-6058 |
Second Address | Lincoln, NE 68526-6058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2013 |
Last Update Date | 03/01/2020 |