Provider Demographics
NPI:1295353852
Name:FRIEDMAN-WHEELER, DARA G (PHD)
Entity type:Individual
Prefix:DR
First Name:DARA
Middle Name:G
Last Name:FRIEDMAN-WHEELER
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 1:117 BRANDON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1128
Mailing Address - Country:US
Mailing Address - Phone:410-823-0510
Mailing Address - Fax:
Practice Address - Street 1:117 BRANDON RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1128
Practice Address - Country:US
Practice Address - Phone:410-823-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04645103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral