Individual
REBEKAH A FREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
117 N GARTH AVE, COLUMBIA, MO 65203-4103
(573) 449-2581
(573) 449-2583
Mailing address
117 N GARTH AVE, COLUMBIA, MO 65203-4103
(573) 449-2581
(573) 449-2583
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2004024548
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649269622
GROUP BILLING NPI
MO
01
—
193115
BCBS I.D.
MO
01
—
431008405
GROUP TAX I.D.
MO
05
—
497307504
—
MO
01
—
506201904
HCY MEDICAID NUMBER
MO
Enumeration date
10/31/2005
Last updated
08/18/2010
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