Provider Demographics
NPI:1538214747
Name:FREEMAN, LAURIE B (MA)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:B
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 W 86TH ST STE E7
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2246
Mailing Address - Country:US
Mailing Address - Phone:317-506-5988
Mailing Address - Fax:
Practice Address - Street 1:1261 W 86TH ST STE E7
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2246
Practice Address - Country:US
Practice Address - Phone:317-506-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
IN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist