Provider Demographics
NPI:1083273338
Name:FRIEDMAN, JODIE LYNN (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:LYNN
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 FAIRWEATHER CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3021
Mailing Address - Country:US
Mailing Address - Phone:240-723-6603
Mailing Address - Fax:
Practice Address - Street 1:300 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1005
Practice Address - Country:US
Practice Address - Phone:301-924-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist