Provider Demographics
NPI:1063837177
Name:FRIEDMAN, WENDY SUE (MPH, RMFTI)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SUE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MPH, RMFTI
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:CORN
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH,RMFTI
Mailing Address - Street 1:1800 S OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7734
Mailing Address - Country:US
Mailing Address - Phone:610-457-9408
Mailing Address - Fax:
Practice Address - Street 1:1800 S OCEAN DR APT 2410
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7727
Practice Address - Country:US
Practice Address - Phone:610-457-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT1412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist