Provider Demographics
NPI:1013450444
Name:ARY, FREDA (LPC)
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:
Last Name:ARY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5143 HIGHWAY 531
Mailing Address - Street 2:
Mailing Address - City:DUBBERLY
Mailing Address - State:LA
Mailing Address - Zip Code:71024-2955
Mailing Address - Country:US
Mailing Address - Phone:318-458-9473
Mailing Address - Fax:
Practice Address - Street 1:5143 HIGHWAY 531
Practice Address - Street 2:
Practice Address - City:DUBBERLY
Practice Address - State:LA
Practice Address - Zip Code:71024-2955
Practice Address - Country:US
Practice Address - Phone:318-458-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-03
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health