Provider Demographics
NPI:1700134228
Name:FREEMAN, ASHLEY H (PHD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:H
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 WOODLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6504
Mailing Address - Country:US
Mailing Address - Phone:152-577-1555
Mailing Address - Fax:
Practice Address - Street 1:3408 WOODLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6504
Practice Address - Country:US
Practice Address - Phone:152-577-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004905103T00000X, 103TC1900X, 103TP2701X, 103TC0700X
NC4327103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy