Provider Demographics
NPI:1427117969
Name:FRIEDMAN, JULIE A (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 CRESTWOOD PKWY NW
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1805
Mailing Address - Country:US
Mailing Address - Phone:770-923-4100
Mailing Address - Fax:770-923-2277
Practice Address - Street 1:3675 CRESTWOOD PKWY NW
Practice Address - Street 2:SUITE 550
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1805
Practice Address - Country:US
Practice Address - Phone:770-923-4100
Practice Address - Fax:770-923-2277
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001496103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBBFFMedicare ID - Type Unspecified