Provider Demographics
NPI:1164534889
Name:FRIEDMAN, LAWRENCE JAY (MA)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:JAY
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 SMOKE TREE CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-1160
Mailing Address - Country:US
Mailing Address - Phone:209-951-7371
Mailing Address - Fax:209-951-7371
Practice Address - Street 1:2853 SMOKE TREE CIR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-1160
Practice Address - Country:US
Practice Address - Phone:209-951-7371
Practice Address - Fax:209-951-7371
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist