Provider Demographics
NPI:1740508860
Name:FREEMAN, EDDI ANN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:EDDI
Middle Name:ANN
Last Name:FREEMAN
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 1:4288 S DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6850
Mailing Address - Country:US
Mailing Address - Phone:305-992-7188
Mailing Address - Fax:
Practice Address - Street 1:2701 S BAYSHORE DR
Practice Address - Street 2:SUITE 401
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-5309
Practice Address - Country:US
Practice Address - Phone:305-992-7188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 2079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist