Provider Demographics
NPI:1801674650
Name:FREAS SPEECH THERAPY
Entity type:Organization
Organization Name:FREAS SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:410-424-5946
Mailing Address - Street 1:802 MAXALEA CT
Mailing Address - Street 2:
Mailing Address - City:IDLEWYLDE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1314
Mailing Address - Country:US
Mailing Address - Phone:410-591-6130
Mailing Address - Fax:
Practice Address - Street 1:320 EAST TOWSONTOWN BLVD
Practice Address - Street 2:TERRACE LEVEL
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2128
Practice Address - Country:US
Practice Address - Phone:410-424-5946
Practice Address - Fax:410-769-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty