Provider Demographics
NPI:1376168351
Name:FREEMAN, VANESSA FRIERSON (PH D)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:FRIERSON
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 KYNLYN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2419
Mailing Address - Country:US
Mailing Address - Phone:347-276-1347
Mailing Address - Fax:
Practice Address - Street 1:1248 KYNLYN DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2419
Practice Address - Country:US
Practice Address - Phone:347-276-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty