Individual
MS. IVY FLORENCE FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
10 EASTERLY AVENUE, RUTLAND, VT 05701
(802) 773-1116
(802) 773-1116
Mailing address
10 EASTERLY AVENUE, RUTLAND, VT 05701
(802) 773-1116
(802) 773-1116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000052
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006859
—
VT
01
—
5660
BLUE CROSS BLUE SHIELD
VT
Enumeration date
10/26/2006
Last updated
07/08/2007
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