Provider Demographics
NPI:1760965040
Name:DR MICHELLE L FRIEDMAN LLC
Entity Type:Organization
Organization Name:DR MICHELLE L FRIEDMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:518-253-9289
Mailing Address - Street 1:3210 HATTON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4515
Mailing Address - Country:US
Mailing Address - Phone:518-253-9289
Mailing Address - Fax:
Practice Address - Street 1:3210 HATTON RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4515
Practice Address - Country:US
Practice Address - Phone:518-253-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty