Individual
MR. KYLE FREDRIK FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
20942 SPINNAKER ST, BEND, OR 97701-8428
(541) 640-1160
Mailing address
20942 SPINNAKER ST, BEND, OR 97701-8428
(541) 640-1160
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6011
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HB994A
MEDICARE
CA
Enumeration date
12/18/2006
Last updated
01/18/2023
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