Provider Demographics
NPI:1669016366
Name:FREYRE, ESTHER MARIA
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:MARIA
Last Name:FREYRE
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 1:15840 SW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4590
Mailing Address - Country:US
Mailing Address - Phone:954-471-0121
Mailing Address - Fax:
Practice Address - Street 1:15840 SW 43RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4590
Practice Address - Country:US
Practice Address - Phone:954-471-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-18-72534106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician