Doctor Name: | ERIC FREAS |
NPI Number: | 1578929717 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED. A.T.,C. L/A.T. |
License Number: | 0119 |
Business Practice Address: | 2801 N Izabel St Flagstaff, AZ - 860043452 |
Business Phone Number: | 9282201223 |
Business Fax Number: | |
Mailing Address: | 2801 N Izabel St, FLAGSTAFF |
State: | AZ |
Postal Code: | 860043452 |
Phone Number: | 9282201223 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2016 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0119 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |