Provider Demographics
NPI:1013183425
Name:FRIEDMAN, SHANA (MS)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 SW 80TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4931
Mailing Address - Country:US
Mailing Address - Phone:786-662-8531
Mailing Address - Fax:786-662-4649
Practice Address - Street 1:6900 SW 80TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4931
Practice Address - Country:US
Practice Address - Phone:786-662-8531
Practice Address - Fax:786-662-4649
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH11234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health