Individual
DR. RONDA WISLEDER FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PD.D., LMFT
Contact information
Practice address
2663 FARRAGUT DR, SUITE A, SPRINGFIELD, IL 62704-1462
(217) 793-0680
(217) 793-0684
Mailing address
2663 FARRAGUT DR, SUITE A, SPRINGFIELD, IL 62704-1462
(217) 793-0680
(217) 793-0684
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BC/BS
8432042
IL
Enumeration date
09/22/2006
Last updated
07/08/2007
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