Provider Demographics
NPI:1902165319
Name:FREEMAN, TRESIA LYVETTE (BHRS)
Entity type:Individual
Prefix:MISS
First Name:TRESIA
Middle Name:LYVETTE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 SW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-7005
Mailing Address - Country:US
Mailing Address - Phone:405-417-0836
Mailing Address - Fax:
Practice Address - Street 1:436 SW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-7005
Practice Address - Country:US
Practice Address - Phone:405-417-0836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health