Provider Demographics
NPI:1497983258
Name:FREEMAN, REENA C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:REENA
Middle Name:C
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:REENA
Other - Middle Name:C
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 RENAISSANCE CIR
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2455
Mailing Address - Country:US
Mailing Address - Phone:951-667-5172
Mailing Address - Fax:
Practice Address - Street 1:102 RENAISSANCE CIR
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662
Practice Address - Country:US
Practice Address - Phone:864-538-6906
Practice Address - Fax:864-538-6906
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1503103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical