Organization
FRASER VASELAKOS & ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M. DENISE FRASER VASELAKOS PSY.D. (OWNER)
(708) 645-0798
Entity
Organization
Contact information
Practice address
12627 W 143RD ST, HOMER GLEN, IL 60491-8381
(708) 645-0798
(708) 645-0841
Mailing address
12627 W 143RD ST, HOMER GLEN, IL 60491-8381
(708) 645-0798
(708) 645-0841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004958
IL
Other
Enumeration date
11/08/2006
Last updated
06/19/2008
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