Provider Demographics
NPI:1912744384
Name:FREEMAN, RAGIN L (BCBA, LBA-NY)
Entity type:Individual
Prefix:MS
First Name:RAGIN
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:BCBA, LBA-NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SAINT NICHOLAS AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-3036
Mailing Address - Country:US
Mailing Address - Phone:803-977-0839
Mailing Address - Fax:
Practice Address - Street 1:43 SAINT NICHOLAS AVE APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3036
Practice Address - Country:US
Practice Address - Phone:803-977-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst