Provider Demographics
NPI:1073670162
Name:FREMED, RESA (EDD LMFT)
Entity Type:Individual
Prefix:DR
First Name:RESA
Middle Name:
Last Name:FREMED
Suffix:
Gender:F
Credentials:EDD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 LAKE SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-1311
Mailing Address - Country:US
Mailing Address - Phone:914-763-3546
Mailing Address - Fax:914-514-8074
Practice Address - Street 1:65 LAKE SHORE DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10590-1311
Practice Address - Country:US
Practice Address - Phone:914-763-3546
Practice Address - Fax:914-514-8074
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000281106H00000X
CT000499106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist