Provider Demographics
NPI:1417923046
Name:FRIEND, RONNA M (MA)
Entity Type:Individual
Prefix:MS
First Name:RONNA
Middle Name:M
Last Name:FRIEND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3348
Mailing Address - Country:US
Mailing Address - Phone:541-345-1048
Mailing Address - Fax:541-345-2008
Practice Address - Street 1:3203 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3348
Practice Address - Country:US
Practice Address - Phone:541-345-1048
Practice Address - Fax:541-345-2008
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA5006103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist