Provider Demographics
NPI:1851004493
Name:FRIEDLAND, SHANEY (BHT)
Entity Type:Individual
Prefix:
First Name:SHANEY
Middle Name:
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 N 6TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2953
Mailing Address - Country:US
Mailing Address - Phone:845-200-5640
Mailing Address - Fax:
Practice Address - Street 1:9119 N 7TH ST STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2598
Practice Address - Country:US
Practice Address - Phone:480-296-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician