MEDICARE: MRS. DAGMAR B FRIEDMAN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	106038	MA

General Provider Information

NPI Number	:	1619950300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAGMAR B FRIEDMAN LICSW

Provider Business Mailing Address
First Line	:	45 WEST ST
Second Line	:	#22
City	:	BEVERLY FARMS
State	:	MA
Zip	:	01915-2225
Country	:	US
Telephone Number	:	978-927-3232
Fax Number	:	978-927-3506

Provider Business Practice Location Address
First Line	:	45 WEST ST
Second Line	:	#22
City	:	BEVERLY FARMS
State	:	MA
Zip	:	01915-2225
Country	:	US
Telephone Number	:	978-927-3232
Fax Number	:	978-927-3506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/09/2007

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