Healthcare Provider Details

I. General information

NPI: 1770030942
Provider Name (Legal Business Name): STACY FRIEDMAN DHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W PALMETTO PARK RD # 410
BOCA RATON FL
33486-3325
US

IV. Provider business mailing address

11886 FOXBRIAR LAKE TRL
BOYNTON BEACH FL
33473-7830
US

V. Phone/Fax

Practice location:
  • Phone: 561-899-7669
  • Fax:
Mailing address:
  • Phone: 561-899-7669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: