Provider Demographics
NPI:1003583758
Name:FREEMAN, DANIELLE A (LPN, IBCLC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:A
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LPN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BASSETT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-1832
Mailing Address - Country:US
Mailing Address - Phone:203-805-8873
Mailing Address - Fax:
Practice Address - Street 1:3074 WHITNEY AVE STE 211
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-2391
Practice Address - Country:US
Practice Address - Phone:203-769-9312
Practice Address - Fax:860-809-8406
Is Sole Proprietor?:No
Enumeration Date:2021-08-29
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1295075164W00000X
CTL-303617174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse