Provider Demographics
NPI:1144480948
Name:FLOYD-FREEMAN, JUANITA (LMSW)
Entity type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:
Last Name:FLOYD-FREEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4676 VANCOUVER ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-5032
Mailing Address - Country:US
Mailing Address - Phone:313-445-8382
Mailing Address - Fax:
Practice Address - Street 1:4676 VANCOUVER ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-5032
Practice Address - Country:US
Practice Address - Phone:313-445-8382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010330351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical