Provider Demographics
NPI:1568291953
Name:FREEMAN, KEISHA D
Entity type:Individual
Prefix:
First Name:KEISHA
Middle Name:D
Last Name:FREEMAN
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 1:1450 NEWNAN CROSSING BLVD E APT 2302
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-0005
Mailing Address - Country:US
Mailing Address - Phone:706-402-8890
Mailing Address - Fax:
Practice Address - Street 1:1450 NEWNAN CROSSING BLVD E APT 2302
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-0005
Practice Address - Country:US
Practice Address - Phone:706-402-8890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty