Provider Demographics
NPI:1609909118
Name:FRIEDMAN, HARRIS LEONARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:LEONARD
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 TOM COKER RD SW
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-7456
Mailing Address - Country:US
Mailing Address - Phone:863-675-4138
Mailing Address - Fax:863-675-1467
Practice Address - Street 1:1255 TOM COKER RD SW
Practice Address - Street 2:
Practice Address - City:LABELLE
Practice Address - State:FL
Practice Address - Zip Code:33935-7456
Practice Address - Country:US
Practice Address - Phone:863-675-4138
Practice Address - Fax:863-675-1467
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3029103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical