Provider Demographics
NPI:1497044788
Name:FREEMAN, JUDITH D (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:D
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 LAKEMONT DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-2124
Mailing Address - Country:US
Mailing Address - Phone:615-973-8302
Mailing Address - Fax:
Practice Address - Street 1:860 LAKEMONT DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-2124
Practice Address - Country:US
Practice Address - Phone:615-973-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000000204OtherTN. DIVISION OF HEALTH RELATED BOARDS