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Individual

WADE PETER FREUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC, LAMFT

Contact information

Practice address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9471
Mailing address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9471

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1809135
AR
101YP2500X
Professional Counselor
F1906010
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235842795
AR
Enumeration date
08/14/2019
Last updated
09/02/2020
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