Provider Demographics
NPI:1730959958
Name:FREEDMAN, KIT STUART (MS, MA, PPC)
Entity type:Individual
Prefix:MR
First Name:KIT
Middle Name:STUART
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MS, MA, PPC
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:STUART
Other - Last Name:FREEDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, MA, PPC
Mailing Address - Street 1:502 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:502 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3704
Practice Address - Country:US
Practice Address - Phone:307-349-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1414101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor