Provider Demographics
NPI:1427593417
Name:FREEMAN, AYOCA
Entity Type:Individual
Prefix:
First Name:AYOCA
Middle Name:
Last Name:FREEMAN
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 1:275 SCOTT MILL RD
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-4366
Mailing Address - Country:US
Mailing Address - Phone:706-436-2374
Mailing Address - Fax:
Practice Address - Street 1:275 SCOTT MILL RD # RF
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-4366
Practice Address - Country:US
Practice Address - Phone:706-436-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator