Provider Demographics
NPI:1700216900
Name:FREEBY, NANCY EILEEN (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:EILEEN
Last Name:FREEBY
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 LOIS LN
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-2852
Mailing Address - Country:US
Mailing Address - Phone:208-631-5675
Mailing Address - Fax:
Practice Address - Street 1:1425 LOIS LN
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-2852
Practice Address - Country:US
Practice Address - Phone:208-631-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist