Provider Demographics
NPI:1811580723
Name:FREIWIRTH, JUDITH (PSYD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:FREIWIRTH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PURITAN LN
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2434
Mailing Address - Country:US
Mailing Address - Phone:978-443-7201
Mailing Address - Fax:
Practice Address - Street 1:111 PURITAN LN
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2434
Practice Address - Country:US
Practice Address - Phone:978-443-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6088-PY-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist