Provider Demographics
NPI:1114971884
Name:FREED, AMY M (AUD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:FREED
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 W 4TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1909
Mailing Address - Country:US
Mailing Address - Phone:717-247-4327
Mailing Address - Fax:717-248-1425
Practice Address - Street 1:1130 W 4TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1909
Practice Address - Country:US
Practice Address - Phone:717-247-4327
Practice Address - Fax:717-248-1425
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000948L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAO20494Medicare ID - Type Unspecified