Provider Demographics
NPI:1447799812
Name:FRIEDMAN, NOELLE (BCBA)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CARILLON PKWY UNIT 211
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1376
Mailing Address - Country:US
Mailing Address - Phone:347-860-4603
Mailing Address - Fax:
Practice Address - Street 1:250 CARILLON PKWY UNIT 211
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1376
Practice Address - Country:US
Practice Address - Phone:347-860-4603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-18
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-27205103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst