Provider Demographics
NPI:1477165645
Name:FREELS, ELIZA WISEMAN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELIZA
Middle Name:WISEMAN
Last Name:FREELS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WINKLERS CREEK RD STE C
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7838
Mailing Address - Country:US
Mailing Address - Phone:828-305-3022
Mailing Address - Fax:
Practice Address - Street 1:245 WINKLERS CREEK RD STE C
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7838
Practice Address - Country:US
Practice Address - Phone:828-773-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7181235Z00000X
NC30003423235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist