Individual
MR. MICHAEL G FREEZE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAADC
Contact information
Practice address
124 W WALNUT ST, NEVADA, MO 64772-2302
(417) 448-9949
(417) 448-9949
Mailing address
124 W WALNUT ST, NEVADA, MO 64772-2302
(417) 448-9949
(417) 448-9949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19634
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184014946
—
MO
Enumeration date
05/21/2025
Last updated
05/21/2025
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