Provider Demographics
NPI:1912499575
Name:FREIJ, WAFFA JAMIL
Entity Type:Individual
Prefix:
First Name:WAFFA
Middle Name:JAMIL
Last Name:FREIJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SWEET BRIAR RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1389
Mailing Address - Country:US
Mailing Address - Phone:401-525-6798
Mailing Address - Fax:
Practice Address - Street 1:21 SWEET BRIAR RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1389
Practice Address - Country:US
Practice Address - Phone:401-525-6798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker