Provider Demographics
NPI:1770531642
Name:FREEMAN, SALLIE B (PHD, BSN, CGC)
Entity type:Individual
Prefix:PROF
First Name:SALLIE
Middle Name:B
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHD, BSN, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 CLIFTON RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1226
Mailing Address - Country:US
Mailing Address - Phone:404-778-8484
Mailing Address - Fax:
Practice Address - Street 1:2165 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5307
Practice Address - Country:US
Practice Address - Phone:404-778-8484
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN072858163W00000X
170100000X, 170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Not Answered170300000XOther Service ProvidersGenetic Counselor, MS