Provider Demographics
NPI:1184283756
Name:FRIEDER, DANIELLE (PSYD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:FRIEDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:FRIEDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-0295
Mailing Address - Country:US
Mailing Address - Phone:312-481-8181
Mailing Address - Fax:
Practice Address - Street 1:6992 CALLE DEL PAZ W
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6426
Practice Address - Country:US
Practice Address - Phone:248-842-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11741103TC0700X
IL071.010321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical