Provider Demographics
NPI:1134646029
Name:FREEMAN, ALICE M (BS NUTRITION, CNHP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:BS NUTRITION, CNHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 TWINRIDGE LN STE 6
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5270
Mailing Address - Country:US
Mailing Address - Phone:804-320-1220
Mailing Address - Fax:804-320-1520
Practice Address - Street 1:705 TWINRIDGE LN STE 6
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5270
Practice Address - Country:US
Practice Address - Phone:804-320-1220
Practice Address - Fax:804-320-1520
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education