Most Relevant Information
Provider Data
| NPI Number: | 1003465832 |
| Provider Name: | LISA REELLA FREEMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: | 6801103218 |
Most Important Dates
| Enumeration Date: | 09/04/2019 |
| Last Updated: | 09/04/2019 |
Provider Practice Location
15200 PEARSON ST
OAK PARK
MI
482372529
Practice Location Phone/Fax
| Phone: | 2486671231 |
| Fax: |
Provider Mailing Location
15200 PEARSON ST
OAK PARK
MI
482372529
Provider Mailing Phone/Fax
| Phone: | 2486671231 |
| Fax: |