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General NPI Number Information
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NPI Number | 1538545363
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Entity Type | Individual
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Provider Name | ELLEN FRIEDMAN MSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 13055 WEST MCDOWELL RD G-112
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City | AVONDALE
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State | AZ
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Zip | 85392
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Country | US
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Telephone | 623-792-5021
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 LAKE MARY ROAD APT. 382
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City | FLAGSTAFF
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State | AZ
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Zip | 86005
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Country | US
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Telephone | 404-664-1880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | AZ
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