Provider Demographics
NPI:1568603298
Name:FREUDENBERG, RENE
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:FREUDENBERG
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 1:2399 CROSSWALK LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8060
Mailing Address - Country:US
Mailing Address - Phone:812-453-8475
Mailing Address - Fax:812-490-0511
Practice Address - Street 1:2399 CROSSWALK LN
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8060
Practice Address - Country:US
Practice Address - Phone:812-453-8475
Practice Address - Fax:812-490-0511
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator