MEDICARE: DR. JUDITH A. FRIEDMAN PH.D., LCSW

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	1041C0700X	Clinical Social Worker	SW0000271	FL

General Provider Information

NPI Number	:	1750386694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH A. FRIEDMAN PH.D., LCSW

Provider Business Mailing Address
First Line	:	2750 N 29TH AVE
Second Line	:	STE 208
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1518
Country	:	US
Telephone Number	:	954-922-8520
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 N 29TH AVENUE
Second Line	:	STE 208
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-1518
Country	:	US
Telephone Number	:	954-922-8520
Fax Number	:

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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