Provider Demographics
NPI:1770655052
Name:FRIEDLANDER, LAURIE JEAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:JEAN
Last Name:FRIEDLANDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ELM TER
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1601
Mailing Address - Country:US
Mailing Address - Phone:610-667-3404
Mailing Address - Fax:
Practice Address - Street 1:110 N ESSEX AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2206
Practice Address - Country:US
Practice Address - Phone:215-906-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015426103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100799Medicare ID - Type Unspecified