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Individual

SHAWN EUGENE FREEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
2030 S NATIONAL AVE, STE 105, SPRINGFIELD, MO 65804-2222
(417) 820-9590
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2002030479
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497725147
MO
01
431560263
TRICARE
MO
Enumeration date
01/25/2006
Last updated
05/09/2013
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