Provider Demographics
NPI:1821190992
Name:FRIED, PAULA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:FRIED
Suffix:
Gender:F
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:PO BOX 2693
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67402-2693
Mailing Address - Country:US
Mailing Address - Phone:785-825-1101
Mailing Address - Fax:
Practice Address - Street 1:326 N FRONT ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2038
Practice Address - Country:US
Practice Address - Phone:785-825-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0768103TC0700X
KS220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS010936OtherBLUE CROSS BLUE SHIELD
KS010936Medicare ID - Type Unspecified