Provider Demographics
NPI:1376329102
Name:FREEBURN, ANITA MARIE
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:FREEBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 86TH ST APT A2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3226
Mailing Address - Country:US
Mailing Address - Phone:347-445-4448
Mailing Address - Fax:
Practice Address - Street 1:675 86TH ST APT A2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3226
Practice Address - Country:US
Practice Address - Phone:347-445-4448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health