Provider Demographics
NPI:1982200572
Name:FREE, MAGHEN LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:MAGHEN
Middle Name:LYNN
Last Name:FREE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MAGHEN
Other - Middle Name:LYNN
Other - Last Name:FREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PITNER
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 E ROYAL LN STE 290
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3602
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst