Provider Demographics
NPI:1215377403
Name:FREUDENHEIM, STEPHANIE NOEL (COMS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:NOEL
Last Name:FREUDENHEIM
Suffix:
Gender:F
Credentials:COMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 BRASIE CT
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8992
Mailing Address - Country:US
Mailing Address - Phone:843-810-9770
Mailing Address - Fax:
Practice Address - Street 1:1255 BRASIE CT
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8992
Practice Address - Country:US
Practice Address - Phone:843-810-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2952225CX0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider