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Individual

MRS. JEANNE M FREED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., ATR-BC, LCAT

Contact information

Practice address
939 JOHNSON AVE, RONKONKOMA, NY 11779-6066
(631) 471-7242
(631) 471-5150
Mailing address
939 JOHNSON AVE, RONKONKOMA, NY 11779-6066
(631) 471-7242
(631) 471-5150

Taxonomy

Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001329
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578516738
NY
Enumeration date
02/25/2010
Last updated
02/25/2010
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