Provider Demographics
NPI:1225872104
Name:FREEBURG, KYRA
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:FREEBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-2383
Mailing Address - Country:US
Mailing Address - Phone:619-535-0173
Mailing Address - Fax:
Practice Address - Street 1:685 FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2383
Practice Address - Country:US
Practice Address - Phone:619-535-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor