Provider Demographics
NPI:1821269077
Name:WELLS-FRIEDMAN, MARGARE ALICE (MS, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:MARGARE
Middle Name:ALICE
Last Name:WELLS-FRIEDMAN
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 S. PARSONS AVE
Mailing Address - Street 2:ALL CHILDRENS SPECIALTY CARE OF BRANDON
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:813-436-5904
Mailing Address - Fax:813-436-5901
Practice Address - Street 1:885 S. PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-436-5904
Practice Address - Fax:813-436-5901
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist