Provider Demographics
NPI:1053330167
Name:FREEMAN, LYNNE DARLENE (MFT)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:DARLENE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 LAUREL CANYON BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1715
Mailing Address - Country:US
Mailing Address - Phone:818-754-1575
Mailing Address - Fax:818-762-6482
Practice Address - Street 1:4320 LAUREL CANYON BLVD APT 4
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1715
Practice Address - Country:US
Practice Address - Phone:818-754-1575
Practice Address - Fax:818-762-6482
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist