Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 51778 | TX |
NPI | 1003083890 |
---|---|
Provider Name | Ms. Angela Rene Freeman |
First Address | Dallas, TX 75235-2215 |
Second Address | Dallas, TX 75235-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/05/2008 |