Provider Demographics
NPI:1992174254
Name:FREEMAN, CANDICE (OTD, MOT, OTR)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:OTD, MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CALLAHAN DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5107
Mailing Address - Country:US
Mailing Address - Phone:214-870-1473
Mailing Address - Fax:
Practice Address - Street 1:8355 WALNUT HILL LN STE 225A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4241
Practice Address - Country:US
Practice Address - Phone:972-685-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112074225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics