Organization Name: | FREEDOM PSYCHIATRY PLLC |
NPI Number: | 1689918617 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM COLLINS (MEMBER) |
Mailing Address: | 3042 Plantation Dr Sellersburg |
State: | IN US |
Postal Code: | 471729136 |
Phone Number: | 6067766309 |
Fax Number: | 6063630141 |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 05/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |