Provider Demographics
NPI:1619695871
Name:ROBERTS-FREEMAN, TERESA LYNN (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:ROBERTS-FREEMAN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:SEAGRAVES
Mailing Address - State:TX
Mailing Address - Zip Code:79359-0263
Mailing Address - Country:US
Mailing Address - Phone:806-535-3978
Mailing Address - Fax:
Practice Address - Street 1:602 18TH STREET
Practice Address - Street 2:
Practice Address - City:SEAGRAVES
Practice Address - State:TX
Practice Address - Zip Code:79359
Practice Address - Country:US
Practice Address - Phone:806-535-3978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist