Provider Demographics
NPI:1639549306
Name:FREEMAN, PAMELA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FREEMAN
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 1:6213 N WINDERMERE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-3422
Mailing Address - Country:US
Mailing Address - Phone:318-294-2411
Mailing Address - Fax:318-675-0226
Practice Address - Street 1:6213 N WINDERMERE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3422
Practice Address - Country:US
Practice Address - Phone:318-294-2411
Practice Address - Fax:318-675-0226
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health