Provider Demographics
NPI:1720063258
Name:FRIEDMAN, DEBRA ANN (MD SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MD SLP CCC
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:HELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SLP CCC
Mailing Address - Street 1:8222 CANOPY TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4493
Mailing Address - Country:US
Mailing Address - Phone:954-255-8015
Mailing Address - Fax:954-255-8015
Practice Address - Street 1:8222 CANOPY TER
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4493
Practice Address - Country:US
Practice Address - Phone:954-255-8015
Practice Address - Fax:954-255-8015
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01033429OtherASHA CERTIFIED