Individual
MS. WANDA JEAN FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
11 UNION ST S STE 207, CONCORD, NC 28025-1004
(704) 837-0084
(704) 956-2325
Mailing address
11 UNION ST S, CONCORD, NC 28025-5059
(304) 960-9348
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CCSI20285
NC
Other
Enumeration date
09/26/2011
Last updated
10/13/2023
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