Organization
JOEL B FREID PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL BENJAMIN FREID PH.D. (PRESIDENT)
(863) 644-0506
Entity
Organization
Contact information
Practice address
2020 W LAKE PARKER DR, LAKELAND, FL 33805-5005
(863) 682-7580
(863) 683-9564
Mailing address
5925 IMPERIAL PKWY, SUITE 128, MULBERRY, FL 33860-8476
(863) 644-0506
(863) 644-7522
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 0002213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346350600
INDIVIDUAL NPI
FL
Enumeration date
12/27/2006
Last updated
08/22/2020
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