Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | 2-2209 | TX |
N | 103T00000X | Psychologist | 2-2209 | TX |
Y | 102L00000X | Psychologist | 6305 | OH |
Y | 103T00000X | Psychologist | 6305 | OH |
NPI | 1013097369 |
---|---|
Provider Name | Lois Friedman |
First Address | Euclid, OH 44117-1714 |
Second Address | Westlake, OH 44145-1582 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 15/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000229160 | UNISON (01) | OH |
000000533012 | ANTHEM (01) | OH |
2727731 | (05) | OH |
414972 | WELLCARE MEDICAID (01) | OH |
7710901 | AETNA (01) | OH |
R54398 | (02) |