Provider Demographics
NPI:1932452745
Name:FREEMAN, KATIE L (PSYD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:RODAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1620 BALTIMORE PIKE #433
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317
Mailing Address - Country:US
Mailing Address - Phone:302-444-8155
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-444-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017810103G00000X, 103TC0700X, 103TC2200X
DEB1-0000926103TC0700X, 103G00000X, 103G00000X
DEB100000926103TC2200X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation