Provider Demographics
NPI:1508329061
Name:FREEMAN, VIRGINIA THERESE RICH (AUD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:THERESE RICH
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:THERESE
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1031 BIENVENEDA AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2314
Mailing Address - Country:US
Mailing Address - Phone:513-375-6787
Mailing Address - Fax:
Practice Address - Street 1:1515 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5337
Practice Address - Country:US
Practice Address - Phone:513-375-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3362231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist