Provider Demographics
NPI:1124508742
Name:FREEMAN, BETHANY I (MS)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:FREEMAN
Suffix:I
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 N CASSIUS LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7110
Mailing Address - Country:US
Mailing Address - Phone:479-747-6840
Mailing Address - Fax:
Practice Address - Street 1:600 S DOGWOOD ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3922
Practice Address - Country:US
Practice Address - Phone:479-747-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist