Provider Demographics
NPI:1629215256
Name:FREEMAN, TONYA M (CCCSLP, BCBA)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CCCSLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 FROST RD
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4355
Mailing Address - Country:US
Mailing Address - Phone:330-963-8600
Mailing Address - Fax:330-963-8680
Practice Address - Street 1:899 FROST RD
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4355
Practice Address - Country:US
Practice Address - Phone:330-963-8600
Practice Address - Fax:330-963-8680
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-14-17823103K00000X
OH9150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst