Healthcare Provider Details

I. General information

NPI: 1194193755
Provider Name (Legal Business Name): AUDREY FRIEDRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 N UNIVERSITY DR STE 350
CORAL SPRINGS FL
33071-6000
US

IV. Provider business mailing address

1725 N UNIVERSITY DR STE 350
CORAL SPRINGS FL
33071-6000
US

V. Phone/Fax

Practice location:
  • Phone: 954-227-2700
  • Fax: 954-227-2704
Mailing address:
  • Phone: 954-227-2700
  • Fax: 954-227-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 8525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: