Provider Demographics
NPI:1982932471
Name:FRIEDLAND, DANIELLE LEE (RD, LDN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEE
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E KENT AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-6026
Mailing Address - Country:US
Mailing Address - Phone:610-715-8135
Mailing Address - Fax:
Practice Address - Street 1:2120 S RESERVE ST
Practice Address - Street 2:PMB 205
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6451
Practice Address - Country:US
Practice Address - Phone:406-721-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22505133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered