Provider Demographics
NPI:1659524445
Name:FRIED, JOY B (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:B
Last Name:FRIED
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 1:4817 BIRDIE LN
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8316
Mailing Address - Country:US
Mailing Address - Phone:734-769-5050
Mailing Address - Fax:734-769-5050
Practice Address - Street 1:4817 BIRDIE LN
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8316
Practice Address - Country:US
Practice Address - Phone:734-769-5050
Practice Address - Fax:734-769-5050
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist