Provider Demographics
NPI:1811676216
Name:FRIEDSAM, ERIN CAREY
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:CAREY
Last Name:FRIEDSAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:CAREY
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 FOX ST
Mailing Address - Street 2:
Mailing Address - City:PERHAM
Mailing Address - State:MN
Mailing Address - Zip Code:56573-2337
Mailing Address - Country:US
Mailing Address - Phone:218-346-2322
Mailing Address - Fax:
Practice Address - Street 1:231 FOX ST
Practice Address - Street 2:
Practice Address - City:PERHAM
Practice Address - State:MN
Practice Address - Zip Code:56573-2337
Practice Address - Country:US
Practice Address - Phone:218-346-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician