Provider Demographics
NPI:1144632498
Name:FREEMAN, ONTWANEECE
Entity type:Individual
Prefix:
First Name:ONTWANEECE
Middle Name:
Last Name:FREEMAN
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 1:4600 OVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-7331
Mailing Address - Country:US
Mailing Address - Phone:405-341-7715
Mailing Address - Fax:405-341-3914
Practice Address - Street 1:39 E 33RD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4604
Practice Address - Country:US
Practice Address - Phone:405-341-7715
Practice Address - Fax:405-341-3914
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator